

Class_ So. 

Book___ 

Gojwiight N°__ 


COPYRIGHT DEPOSIT. 


I 











































MEN AND WOMEN 


THEIR 

STRUCTURE AND FUNCTION 


AND NOW TO SUPPLY THEIR WANTS, DIRECT THEIR 
POWERS, AVOID THEIR AFFLICTIONS, AND 
SUSTAIN THEIR LIVES 


BY / 

FRANKLIN D. CLUM, M. D. 



3 3 

* 3 * * 

•» A 

3 

BOSTON 

D. LOTHROP AND COMPANY 

32 FRANKLIN STREET 













o 


^NTX 

.C-G^ 


s 


Entered according to act of Congress in the year 1882, by 
Franklin D. Clum, M. D , 

In the office of the Librarian of Congress at Washington, D. C. 




PREFACE. 


We all desire health; we want our existence to be 
as pleasing and agreeable as it can be made. We all 
have our rivalries, uncertainties and hard struggles in 
the great battle of life; we all have our' cares and 
afflictions which shorten our existence. There is uni¬ 
versal anxiety in the exciting contest for money, posi¬ 
tion or distinction, and life has its grand successes and 
melancholy failures — its ups and downs. Success in 
business, in society, or in attaining a desired object 
in life, does not imply happiness or freedom from worry 
and disease. We may emerge from poverty and ob-: 
scurity to wealth and position, but care, trouble and 
affliction will still intrude. 

The object of this book is to show how to supply 
the real wants of the human body, how to properly 
direct its powers, how to avoid its afflictions, and how 
to sustain or prolong its life; and although the little 
volume has its imperfections, the author hopes that it 

m 

will assist men and women in passing through life 
with as little trouble, as little anxiety, as little weari¬ 
ness, and as little physical suffering as possible. 

A general knowledge of medical science is of para¬ 
mount importance to all; for if we are enabled to 
prevent a disease we are saved the necessity of curing 


Preface . 


it; but if, through lack of knowledge, the disease is 
not prevented, it must be cured, or it will terminate 
in death, which is a departure from the present scene. 

People generally are getting interested in the well¬ 
being of their bodies; superstitions are vanishing, and 
they have learned that the various loathsome diseases 
are the result of the neglect of sanitary laws, and that 
the remedy lies within their reach. As the hindrances 
of health are being taken away, there will be great 
physical improvement. We are advancing toward phys¬ 
ical perfection, and the future man will be a healthier 
and a better one. 

Children naturally improve upon thejr parents; if 
they do not it is because the laws of health have 
been violated. Careless habits, intemperance, dissipa¬ 
tion, over-work, error in diet, breathing impure air, etc., 
etc., weaken or injure the body; and nine tenths of 
the maladies that afflict us are preventable, as will 
be shown in the following pages. 

Good health is the basis of all physical, mental and 
spiritual improvement, and we should recognize its 
value and carefully guard and protect it. Those who 
plunder our property take from us that which can be 
repaid in time, but what period can repay for a fatal 
disease or injury? Those who ridicule our poverty, 
or reproach our business or profession, upbraid us 
with that which industry may retrieve and integrity 
purify; but what riches can restore the dead to life? 
Can any injury be more fatal ? For the remedy or 
antidote has been neglected or lost. 

Is it not better to prevent a disease, than to take 


Preface. 


the chances of curing it ? If so, physical education 
should be the first thing attended to. We should learn 
how to supply our wants, direct our powers, and avoid 
our ' afflictions; we should learn what are the causes 
of disease and how to avoid them. It matters not 
how familiar we are with medical science, we should 
remember that there is always something to learn, and 
that when respiration ceases, our education is finished, 
and not a moment sooner. 

The matter contained in this volume is based on 
the latest and highest authorities, and is written in a 
style that can be understood by all who know how 
to read. The language used is as clear, direct, concise 
and explicit as is compatible with the subject under 
consideration. 

F. D. Clum, M. D. 

Amsterdam, N K 



CONTENTS. 


PART I. 

MEN AND WOMEN:—THEIR STRUCTURE 

AND FUNCTIONS. 


Introduction.13 

I. —The Bones of the Skeleton.19 

The Human Skull. — The Largest Bones of the Face. — The 
Orbits or Eye Sockets. — Temporal Bone and Ear Cavity.— 
Oral Cavity or Mouth. — The Spine or Vertebral Column.— 
The Thorax or Chest.— The Pelvis.— The Lower Extremities. 

— The Shoulder and Upper Extremities.— The Joints or Artic¬ 
ulations. 

II. —The Muscles.— The Skin.33 

Muscular Power.— The Number of Muscles.— The Layers of 
Skin. 

III. — The Nervous System.— Its Structure. 42 

The Brain.— The Spinal Cord.— Spinal Nerves.— Most Important 
Nerves of the Body.— The Brachial Plexus.— Lumbar of Sacral 
Nerves and Plexuses.—Largest Nerves in the Body— The Cranial 
Nerves. 


IV.— The Nervous System.—Its Function.< 

The Five Senses.— The Sense of Sight.— The Sense of Hearing 

1 







8 


Contents. 


The Sense of Smell.— The Sense of Taste.— The Sense of 
Touch 

V.— The Vascular System.. 68 

The Heart and Circulation of Blood.—The Arteries.— The Capil¬ 
laries.— The Veins.— The Portal System.— Systemic and Pul- 
manic Arteries and Veins.— The Lymphatics. 


VI. — Adipose Tissue or Fat.8 i 

VII. — The Blood. 83 

VIII. -— The Alimentary Canal.— The Salivary 

* 

Glands. 85 

IX. — The Liver.— The Pancreas. 87 

X. — Alimentation .89 

Mastication and Insalivation.— Deglutition.— Digestion. — Ab¬ 
sorption.—Assimilation.— Nutrition. 

/ 

XI. — The Spleen. 94 


XII. — Larynx or Organ of Voice.—The Trachea.. 96 


Action of Larynx when taking Food.— The Windpipe. * 

XIII. — The Lungs. 99 

Respiration.— Animal Heat. 

XIV. — The Urinary Organs. 104 

The Kidneys.— The Ureters.— The Bladder.— The Urethra. 

XV. — The Generative Organs. 108 

Reproduction.— Development. 

XVI. — Man.—Fully Developed and Complete. 114 













Contents. 


9 


PART II. 

HOW TO SUPPLY THEIR WANTS AND 
DIRECT THEIR POWERS. 


Introduction.121 

I. — What is life? .123 

Different Kinds of Force.— Correlation and Convertibility of the 
Forces. 

II. — What is Health ?.128 


Man’s Stature and Weight.— Their Relation to Health.— Dura¬ 
tion of Life. 

III. — How to Sustain Life and Preserve Health. 140 
Pure Air — Its Necessity.— Exercise and Recreation.— Sleep— Its 
Necessity.— Different Kinds of Drinks and their mode of Prep¬ 
aration.— Different Kinds of Food and their Mode of Prepara¬ 
tion.— Facts and Fallacies concerning Eating and Drinking. 

IV. — Alcoholic Drinks. 188 

Their Composition, their medicinal, pleasing, poisonous Effects. 

V. — Narcotics. 206 

Opium— Its Use and Abuse.— Tobacco — Smoking, Chewing, etc. 

PART III. 

HOW TO AVOID THEIR AFFLICTIONS AND 
SUSTAIN THEIR LIVES. 


Introduction .219 

I.— Disease.220 


II. — Death 


226 










IO 


Contents . 


III. —General Diseases.230 

Morbid States of the Blood.— Inflammation.— Boils, Carbuncles 
and Styes.— Hemorrhage.— Scrofula,— Caries of the Spine.— 
Coxalgia or Hip Disease.— Rickets or Rachitis.— Syphilis.— 
Rheumatism.— Gout.— Dropsy.— Hydrophobia.— Cancer. 

IV. — Fevers.267 

Simple Continued Fever.—Typhus Fever.—Typhoid Fever.— 
Cerebro-Spinal Fever.— Relapsing Fever.— Intermittent Fever.— 
Remittent Fever.— Yellow Fever. 

V. — The Eruptive Fevers.284 

How to Prevent the Spread of Infectious Diseases.— Instructions 
for Disinfection.— Small-pox.— Vaccina or Cow-pox.—Chicken- 
pox.— Scarlet Fever.— Measles.— Erysipelas. 

VI. — Diseases of the Nervous System.302 

Inflammation of the Brain.— Apoplexy.— Paralysis.— Sunstroke— 
Headache. — Insanity. — Convulsions. — Epilepsy. — Hysteria.— 
Chorea or St. Vitus’s Dance.— Tetanus.— Neuralgia. 

VII. — Diseases of the Organs of Respiration 

and Circulation.332 

Catarrh.—Bronchitis.— Pleurisy.— Pneumonia.— Phthisis or Con¬ 
sumption.— Asthma.— Croup. — Whooping Cough. — Diphthe¬ 
ria.— Disease of the Heart. 

VIII. — Diseases of the Alimentary Canal.359 

Mumps.— Tonsilitis or Quinsy.— Dyspepsia.— Diarrhoea. — Dys¬ 
entery.— Cholera.— Colic.— Constipation.— Intestinal Worms. 

IX. — Diseases of the Liver.373 

Congestion of the Liver.— Inflammation of the Liver.— Gall-stones. 

— Jaundice. 

X. — Diseases of the Kidneys.380 

Bright’s Disease.— Diabetes. 

XI. — Diseases of the Skin.387 

XII. — Surgical Accidents and Emergencies... ,389 
Wounds.— Fractures.— Dislocations.— Asphyxia.— Poisons. 












PART I. 


THE HUMAN BODY: 

ITS STRUCTURE AND FUNCTIONS. 



4 


/ 







MEN AND WOMEN. 


THEIR STRUCTURE AND FUNCTION. 


INTRODUCTION. 

T HOSE unacquainted with the science of medi¬ 
cine and surgery, find little or nothing to inter¬ 
est them in the structure of a human being. They 
consider anatomical reading dry, and recoil with horror 
from the act of dissecting, or separating and taking 
to pieces the different parts of the human body, 
to discover their situation, structure and economy; 
still a knowledge of the structure and functions of 
the bones, ligaments, muscles, nerves, arteries, veins, 
glands and organs of the human body, is of para¬ 
mount importance in the preservation of health 
and curing disease, because no object can be 
understood by itself alone; it is a well-known fact 
that we understand anything the better the more 
we know of other things distinct from, yet related 
to it. 

With a knowledge of the structure and function 
of the human body we are better prepared to supply 

13 



Introduction. 


its wants, direct its powers, avoid its afflictions, and 
sustain its life, than we would be without it. A 
mechanic to properly repair a piece of mechanism, 
must have a knowledge of its intricate and delicate 
machinery; so with those who would cure or repair 
any disease or injury to the human body; they 
must have a knowledge of the component and con¬ 
stituent parts of the body. 

The ancient philosophers carefully considered the 
organization and functions of the human body, and 
admitted the utility of anatomical knowledge ; but 
the prejudices of every religious creed, from the 
most remote period, interdicted the dissection of 
human subjects ; and the anatomist’s knowledge, 
being obtained almost exclusively from the lower 
animals, was vague and superficial; they were, 
therefore, incapable of tracing the progress of disease, 
and the serious and fatal disorders were ascribed 
to the powers of sorcery. Various superstitious 
practices were resorted to in order to dispel the 
supposed charm and appease the wrath of the 
offended gods, and thus endeavor to cure the sick. 

The first writings on the subject of anatomy 
are supposed to have been by Hippocrates (who 
was a native of Cos, an island of the Aegean, and 
who is often designated as the “ Father of Medi¬ 
cine”), over four hundred years before the Christian 
Era; and the first recorded anatomical dissection 
was made by his friend Democritus, of Abdera. 


The Ancient Philosophers. 


Ptolemy I., a Macedonian, founder of the Greco- 
Egyptian dynasty of the Lagides, applied himself 
to the promotion of commerce, literature, science 
and the arts, in his dominions after the fall of 
Antigonus; philosophers, poets and painters assem¬ 
bled at his court, and the foundations were laid 
in his palace at Alexandria, Egypt, for an insti¬ 
tution with a museum and library, which after¬ 
wards contained seven hundred thousand volumes 
for educational purposes. 

Anatomy was publicly taught there among other 
sciences. Herophilus and Erasistratus were the 
distinguished anatomists at that time, and they 
greatly improved the science by more accurate 
and extended observations. It is said that Heroph¬ 
ilus obtained permission from those in authority 
to dissect living criminals, which greatly extended 
his anatomical knowledge, but at the cost of 
terrible cruelty and punishment to the criminals. 

Ptolemy II., who became ruler in 285 b. c., 
spared no pains in extending scientific knowledge 
to the highest point ; and the Alexandrian Library 
and Museum under his reign became enriched 
with valuable acquisitions. The old-time preju¬ 
dice which had caused anatomy to be ranked 
among the greatest of crimes, was uprooted, and 
physicians were encouraged and permitted to open 
the bodies of the dead, and given ample facilities 
in the pursuit of science; but this state of 


16 Introduction. 

scientific prosperity did not continue, for during 
the next three centuries, although there were 
numerous followers of Herophilus and Erasistratus, 
they are said to have been arrogant and self- 
conceited, and not one of them has been cele¬ 
brated for any anatomical acquirements. 

The Alexandrian Library fell more and more 
into a ruinous state, still it was kept up until 
the time of Galen, a celebrated physician of the 
second century, whose name is well known to 
the medical world. He was born at Pergamus, 
Asia, A. d. 131, and lived seventy years, during 
which time he accomplished more toward the 
advancement of anatomical knowledge than all 
before him. He travelled through Egypt and 
other Eastern countries for the purpose of obtain¬ 
ing a medical and anatomical education; and then 
after practicing four years in his native country 
he went to Rome where physicians at that time 
were greatly encouraged; but when the Roman 
Empire was overwhelmed by barbarous nations, 
science was almost extinguished in Europe. The 
only remains of it were among the Arabians in 
Spain and Asia. 

Practical anatomy and the healing art then 
made but little or no progress for many centuries, 
during which time all classes of people considered 
the bodies of the dead as sacred and inviolable 
subjects; and had such an intense superstitious 


The Ancient Philosophers . 17 

fear of molesting them, that they regarded any 
person who would attempt dissection as great, 
if not a greater criminal than a murderer; 
therefore those interested in the study of anatomy 
and medicine were obliged to confine their inves¬ 
tigations almost exclusively to animals. 

In a. d. 1315, an Italian physician made the 
first dissection of the human body at Bologna, 
that had been made in several hundred years. 
He prepared a treatise on anatomy, in which the 
different parts of the body were described from 
nature, and the work, although very imperfect, was 
considered authority for more than two centuries. 

In the sixteenth century the Emperor Charles 
V., ordered a consultation to be held by divines 
of Salamanca, to determine whether it was law¬ 
ful or not to dissect a dead body. They con¬ 
sidered it horrifying and sacrilegious, but finally, 
for the sake of science, physicians were permit¬ 
ted to dissect and examine quietly and privately, 
the bodies of those persons who had no friends 
or relatives to claim them after death. Vesalius, 
the most celebrated anatomist of his time, was 
appointed the Emperor’s chief physician in 1544, 
and has been called the father of modern 
anatomy; in his disputations with other anato¬ 
mists, they made their appeals to the huiftan 
body, and thus in a few years the art was 
greatly improved. He gave the names to the 


18 


Introduction. 


muscles, most of which are retained to this clay. 

Falloppius, an Italian physician, made many im¬ 
portant discoveries in 1561, and published a work 
on anatomy. Eustachius, another Italian, published 
a work at Venice in 1563, and from this time 
forward anatomical knowledge gradually diffused 
itself throughout Europe. 

Harvey, an English physician, discovered the 
circulation of the blood in 1619, which was one 
of the most important discoveries ever made in 
medicine, and the source of most of the subse¬ 
quent improvement. There has since been abun¬ 
dant facilities for the study of anatomy, and 
medical science has improved and developed 
until at the present day it has reached a more 
perfect standard than at any time in the known 
history of the world. 


I. —THE BONES OF THE SKELETON. 


The bones of the skeleton are connected 

together by strong fibres, or ligaments, and form 
the frame-work or support for the soft parts of 
the body, and give it its general form and solidity. 

Bones are found only in vertebrate animals, and 
furnish cavities for the lodgment and protection 
of vital organs, joints for locomotion, and levers 
for the attachment of muscles. Bone is a com¬ 
plex structure composed of about one third animal 
matter and about two thirds mineral substance, 

intimately combined, which makes them hard, 

strong, and slightly elastic; the more animal 

matter they contain the greater the elasticity. 
The bones of infants contain the most animal 

matter, which diminishes with age, and, as a con¬ 
sequence, the bones of childhood are elastic, and 
those of old age brittle. 

In the entire skeleton there are two hundred 
distinct bones, which enumeration does not include 
the teeth, the three minute bones of each ear, 

and the little bones called sesamoid. The latter 
develop in adult life in those tendons which 

exert considerable pressure upon the parts over 

19 


20 


The Bones of the Skeleton. 


which they glide; they are frequently found in 
persons' whose habits are active and muscular, 
and their number varies. 

During life, bone is permeated by small thread¬ 
like arteries, veins and nerves which run in 
canals called Haversian (after their discoverer), 
which form a network in the interior. These 
canals not only communicate with each other, 
but with the internal cavity and external surface, 
and from them radiate minute tubes called canali- 
culi, which abstract the mineral matter used in form¬ 
ing bone from the blood. 

The central cavity of bones, in which the 
marrow lies, is called the medullary canal. In 
the bones of birds this canal does not contain 
marrow ; it contains air which communicates with 
the bird’s lungs; the bird is thus made lighter, 
and better adapted to flying. 

The marrow in the bones of children is free 
from fat, and is a transparent, reddish fluid of 
tenacious consistency, but thickens as they advance 
in life, and forms vesicles of fat with blood¬ 
vessels distributed through them. 

Bone is closely covered with a membrane called 
on that account periosteum, the use of which is 
to nourish by vessels which pass through it, the 
external layers of bone. Should a portion of the 
periosteum become destroyed, the outer layers of 
the bone will die; but, under favorable circum- 


The Uses of the Bones. 


21 


stances, will be repaired from within. The internal 
layers being supplied by minute internal arteries, 
will inflame, swell, become spongy and porous, 
and form granulations which will push off the 
dead plate and form themselves into new bone 
which supplies the place of the old. 

An injury to a healthy bone produces no pain. 
In amputation the pain is confined to the nerves, 
and in cutting the bone little or no feeling is 
excited; but in a diseased condition the hidden 
sensibility of the bones becomes aroused. Injuries 
may produce inflammation of the bones, which in 
course of time will give rise to the most excru¬ 
ciating pain. 

Anatomists divide bones into four classes; viz. 
long, short, flat and irregular. The long bones 
form a system of levers as in the limbs. The 
short bones are found where strength and com¬ 
pactness are required with slight and limited motion; 
as the eight bones of each wrist, and the "seven 
of each ankle. The flat bones give protection to 
vital parts, and provide a broad surface for the 
attachment of muscles; they are the bones pro¬ 
tecting the brain, the breast bone, the shoulder 
blade, etc. The irregular or mixed bones form 
the spinal column, the jaws, etc. 

The various bones forming the skeleton are in 
two complete sets, united in the centre or median 
li ne — those on the right being exactly like those 


22 


The Bones of the Skeleton. 


on the left — some of these, like those of the 
spinal column and breast bone, although single 
bones, are capable of being divided into two 
exactly corresponding halves. 

The Human Skull. The human skull is com¬ 
posed of two parts — the cranium and face. The 
cranium is composed of eight bones, which form 
a vaulted cavity for inclosing and protecting the 
brain with its membranes, vessels, and nerves. These 
bones are separate in infants, but as age advances 
they gradually unite by what anatomists call 

sutures, which are indented dovetailed seams. 

The bones of the face, fourteen in number, 
form the basis of physiognomy, enter into the 

composition of the mouth, the orbits, or eye 

sockets, form an arch to the nose, and a support 
to the palate. 

The largest Bones of the Face. The largest 
and strongest bone of the face is the inferior max¬ 
illary, which forms the entire lower jaw, the 
chin, and furnishes sockets for the lower teeth ; 
but the most important bones of the face, on 
account of their liability to disease, are the 
superior maxillary or upper jaw bones ; they are two 
in number, united in the median line of the face. 
They are next in size to the lower jaw bone, and 
enter into the formation of three cavities ; the 

roof of the mouth, the floor and outer wall of 
the nose, and the floor of the orbit. 


The Orbits or Eye-sockets. 


23 


In the body of each superior maxillary bone is 
a very important cavity called the antrum, or 
maxillary sinus; it communicates with the nostrils 
by a small opening. Pus or matter occasionally 
collects in this cavity in connection with dis¬ 
eased teeth, causing pain, inflammation, swelling, 
and distortion of the face. The most porous part 
of the jaw bones is the alveolar process, which 
forms the sockets for the teeth, and develops 
with them; when the teeth are extracted, the 
bony structure becomes absorbed. 

The most prominent bones of the face, which 
form the upper and outer part of the cheeks, 
are called malar bones. They are a distinguish¬ 
ing feature in the human countenance, as may 
be seen by comparing the high cheek bones of 
persons of certain nationalities with the regularly 
formed countenances of others. 

The Orbits or Eye-sockets. The orbits or eye- 
sockets are each formed of seven bones; but 
three of these enter into the formation of both 
orbits, so that the two cavities are formed of 
only eleven bones. These three are the frontal, 
which forms the forehead, the ethmoid at the 
root of the nose, and the sphenoid at the base 
of the skull—named sphenoid from its wedge¬ 
like relations with the other bones of the cra¬ 
nium, with all of which it articulates. At the 
front part of the inner wall of the orbits, are 


24 


The Bones of the Skeleton. 


the smallest and most fragile bones of the face; 
they resemble a finger nail in form, thinness, and 
size, and contain a perpendicular canal for lodg¬ 
ing a part of the lachrymal sac and nasal duct 
by which the tears are conveyed into the nostrils. 
(See “The Sense of Sight.”) 

The Temporal Bone and Ear Cavity. The tem¬ 
poral bone at the side and base of the skull, is 
the seat of the organ of hearing. Each temporal 
bone is composed of the squamous, mastoid and 
petrous portions. 

The bone is called temporal because time and 
age is denoted by the hair of an individual first 
becoming gray in its immediate vicinity. The 
squamous portion is the anterior or front, and the 
upper part of the bone* which forms part of the 
side of the skull, and is so named because its 
form is thin and scale-like. The mastoid portion 
is the inferior and posterior, or lower and back, 
part of the bone; it is called mastoid from its 
nipple-like prominence which can be felt behind 
the ear. 

The middle ear or tympanum, and the internal 
ear or labyrinth, are situated in the petrous por¬ 
tion of the temporal bone, which is called petrous 
from its extreme density and hardness. It is 
wedged in at the base of the skull, and points 
inward, forward, and a trifle downward. 

The internal ear, called labyrinth from the 


The Vestibule , Semicircular Canals and Cochlea. 25 

remarkable complexity of its shape, consists, first, 
of a small rounded chamber called the vestibule, 
because it serves as an entrance to the remainder. 
The vestibule communicates with three narrow 
curved passages called semicircular canals. One 
of these canals is directed nearly upward and for¬ 
ward, another upward and sideways, while the third 
is horizontal. The vestibule and canals in a liv¬ 
ing healthy subject are both filled with a clear, 
transparent, fluid-like lymph, in which is suspended 
a membranous sheath or bag which in form is 
an exact repetition of the bony cavities. The 
sheath or bag is also filled with lymph, and it 
floats in the fluid of the labyrinth without touch¬ 
ing the walls of the cavity. The auditory, the 
special nerve of the sense of hearing, is distrib¬ 
uted to this membranous bag, its fibres spreading 
out in its substance. The remaining part, the 
front, of the internal ear is called the cochlea, 
from its resemblance to a snail shell. It is in 
front of the vestibule, with its apex directed for¬ 
ward and outward. It communicates with the 
vestibule, and like it and the semicircular canals, 
is filled with lymph ; some of the fibres of the 
special nerve of hearing pass upward along its 
hollow axis and spread out in a membranous par¬ 
tition between the two parts of the double canal. 

The vestibule, semicircular canals and cochlea, 
together comprise what is called the internal ear 


2 6 


The Bones of the Skeleton. 


or labyrinth. Sound is conveyed from the external 
ear to the internal ear or labyrinth by means of 
a complicated apparatus called the tympanum or 
middle ear. The vestibule has in the outer part 
of its bony wall an oval-shaped opening called 
on that account the oval window, or fenestra ovalis, 
as anatomists express it. It is covered by a thin 
membrane which prevents the fluid in the internal 
ear from escaping. A little less than a quarter 
of an inch outward from the membrane, the cavity 
leading to the internal ear is again completely 
closed by another membrane stretched tightly 
across its diameter. This is the membrane of 
the tympanum, and the cavity between the two 
membranes is called the drum of the ear, middle 
ear, or tympanum. 

The sonorous vibrations of the atmospheric air 
are received by the auricle, the expanded portion 
of the external ear, and are conducted through 
the auditory canal to the membrane of the tym¬ 
panum, from which the sound is transmitted to 
the membrane of the fenestra ovalis by a pecu¬ 
liar chain of three small bones, called the mallet, 
anvil, and stirrup, from the objects which they 
resemble. These bones are united by ligaments 
admitting of slight movement. 

The cavity of the tympanum, like an ordinary 
drum, is filled with air, and communicates with 
the exterior by a side opening; for the mem- 


Nasal Fosses or Nose Cavity. 2 7 

brane of a drum to vibrate freely must have on 
» both sides an equal pressure of air. The open¬ 
ing through which the tympanum is supplied with 
air, is called after the name of its discoverer, the 
Eustachian tube. Its length is about one and 
one half inches, and it is directed downward and 
inward to the pharynx or throat. A drum to be 
of use must also have an arrangement by means 
of which its membranes may be tightened or 
relaxed as occasion may require. Such an arrange¬ 
ment exists in connection with the drum of the 
ear; there are three small muscles attached to 
the little bones, called mallet and stirrup, and 
by their alternate contraction and relaxation they 
draw the bones backward and forward, and thus 
the tension of the membrane of the tympanum 
is increased or diminished. 

The external ear consists of an expanded, 
trumpet-shaped, cartilaginous structure called the 
auricle ; it collects the sound and conveys it 
through the auditory canal, which is a trifle over 
an inch in length to the drum of the ear. 
This canal has fine hairs and a resinous-like 
secretion termed ear wax, which protects it from 
the intrusion of insects. (See “ The Sense of 
Hearing.”) 

Nasal Fosses or Nose Cavity. Fourteen bones — 
all the bones of the face except the two malar 
and lower jaw, and three bones of the cranium, 


28 


The Bones of the Skeleton. 


the frontal, ethmoid and sphenoid — enter into 
the composition of the irregular cavities of the nose, 
which extend from the base of the cranium to 
the roof of the mouth, and are separated by a 
thin verticle septum. 

The cavities communicate with the face by two 
apertures called anterior nares, or nostrils, and 
with the pharynx or throat behind by two pos¬ 
terior nares. Each nasal fossae communicates with 
four sinuses and four cavities. The sinuses are 
hollow spaces containing air, and are the frontal 
above, the sphenoidal behind, and the maxillary 
and ethmoidal on either side, all of them in 
bones of the same name. 

The four cavities with which the no-strils com¬ 
municate, are the orbital by means of the lach¬ 
rymal sac or tear duct; with the mouth by the 
anterior palatine canal; with the cranium by the 
olfactory foramen, and with the spheno-maxillary 
fossa, by the spheno-palatine foramen. 

The Oral Cavity or Mouth. The bones enter¬ 
ing into the formation of the cavity of the mouth 
are the maxillary, or jaw-bones, and the palate 
bones. 

The uses of the cavity are for expression in 
sound, the reception of food, mastication, insali¬ 
vation and gustation, and it has organs and 
agencies by means of which it accomplishes these 
ends. 


The Spine or Vertebral Column. 


29 


The tongue, an important organ in this cavity, 
is attached by its root to a bone called hyoid 
or lingual bone, which is shaped like a horse¬ 
shoe, and is situated between the chin and breast 
bone. The hyoid is attached to no other bone, 
but is held in place by a series of muscles. 

The Spine or Vertebral Column. The long 

chain of bones which extends from the skull 

# 

down the entire length of the body, is called the 
spine, backbone or vertebral column. It consists 
of twenty-four distinct bones, forms the basis of 
support for the head and trunk, connects the 
other parts of the frame, and protects the spinal 
cord. 

The vertebrae, or bones of the spine, are 
divided into the cervical, dorsal and lumbar — the 
regions of the neck, back, and loins ; the number 
of bones forming these divisions being seven for 
the neck, twelve for the back, and five for the 
loins. 

In addition to these the spinal column is 
prolonged below the lumbar vertebrae by a false 
vertebrae consisting of nine bones, but in the 
adult united into two bones called the sacrum 
and coccyx. 

The cervical vertebrae, or those that form the 
neck, are the smallest, and they increase in size 
from the skull down. The first cervical vertebrae 
is called atlas, because it supports the globe of 


30 The Bones of the Skeleton. 

the head; the second is called the axis, from its 
forming a pivot upon which the head rotates. 

Each of the bones of the spine consists of two 
parts; one known as the body, and the other as 
the arch. The former is solid, convex before and 
concave behind. The latter is formed by two 
pedicles and two laminae supporting seven pro¬ 
cesses ; viz. four articular, two transverse, and one 
spinous. 

The bodies of the vertebrae are piled one 
upon another, forming a strong pillar for the 
support of the cranium and trunk; the arches I 
forming behind a hollow cylinder for the protec¬ 
tion of the spinal cord. Between each of the 
vertebrae apertures exist through which the spinal 
nerves pass from the cord. 

The bones of the spine are connected together 
by strong ligaments, and separated by an elastic 
substance called intervertebral cartilage, which 
yields in whichever direction we bend, and after¬ 
ward returns quickly to its original shape; the 
spinal column is thus protected from injury in the 
violent and sudden motions of the body. The 
intervertebral cartilage is constantly yielding to 
pressure during the day, so that when we retire 
to our beds at night our height is one inch less 
than when we arose in the morning; we are also 
a little shorter in old age than in youth. 

The Thorax or Chest. The thorax, or cavity of 


The Pelvis. 


31 


the chest, is that space formed by the ribs — 
twelve on each side — the twelve dorsal vertebrae 
behind, and the breast bone and costal cartilages 
(prolongations of the ribs) in front; it serves to 
lodge and protect the heart, lungs, and largest 
bloodvessels of the body. 

The Pelvis. The pelvis, a bony expansion 
resembling a basin, is a strong, massively con¬ 
structed cavity of large, firm bones, connecting 
the trunk and lower extremities. 

The cavity is formed by four bones; viz. an 
os-innominatum, or hip-bone, on each side, and the 
sacrum, the base of the spine, and coccyx, its 
prolongation, behind. By placing the hands upon 
the hips, the flaring edges of the os-innominatum 
are plainly felt. The intestines and other organs 
are supported in the basin-like cavity of the 
pelvis. 

The Lower Extremities. The two inferior or 
lower extremities are for the purpose of support¬ 
ing and carrying the rest of the body. They are 
each composed of the following bones; viz. a femur 
or thigh bone, which is the longest, largest, and 
strongest bone of the skeleton, and upon which 
the pelvis rests; a patella or knee pan, a flat, 
triangular bone; a tibia and fibula, the bones of 
the leg; seven bones of the tarsus, or ankle; 
five bones of the metatarsus, or foot; and fourteen 
bones of the phalanges or toes. 


32 


The Bones of the Skeleton. 


The Shoulder and Upper Extremities. Two 
bones, called the clavicle or collar bone, and the 
sc r apula or shoulder blade, form the shoulder. 
The bone called the humerus, which extends from 
the shoulder to the elbow, forms the arm ; and 
the radius and ulna, extending from the elbow to 
the wrist, the forearm. The carpus, or wrist, is 
composed of eight bones, the metacarpus or hand, 
five, and the phalanges or fingers, fourteen ; three 
for each finger and two for the thumb. 

The Joints or Articidations. The connection 
between the bones of the skeleton are designated 
by the name of joint or articulation. The ma¬ 
chinery of the joints, in addition to bone, the 
fundamental element, consists of ligaments, carti¬ 
lages, and synovial membranes. 

Ligaments are strong, tough bands or cords, 
composed mainly of white fibrous tissue. They 
serve to connect the bones together, and are 
found in nearly all movable joints. 

Cartilage is a firm elastic substance something 
like rubber, and is either temporary or permanent. 
The temporary is found chiefly in the foetus, 
where it forms the greater part of the skeleton, 
and is afterward replaced by bone. The perma¬ 
nent is found between the joints of individuals 
of all ages where its elasticity enables it to 
break the force of concussions. Permanent car¬ 
tilage is also found in various parts of the body ; 


The Synovial Membrane. 


33 


it serves to prolong the ribs forward to the 
front of the chest, and forms the external ear, 
air passages, etc. 

The synovial membrane is a short wide tube 
attached by its open ends to the margins of the 
articulating extremities of the bones, and covers 
the ligaments which connect the articulating sur¬ 
faces. It secretes a peculiar fluid which is thick, 
viscid and glairy, like the white of an egg, and 
is called on that account synovia. Its use is* to 
lubricate the joints and the sheaths in which the 
tendons play, and it is as necessary as oil to 
the joints of machinery. 

In addition to the synovial membrane, some 
of the joints are assisted in the performance of 
their functions by the bursae, which are mem¬ 
branous cavities, between surfaces which move 
upon each other, and also contain a fluid for lubri¬ 
cating purposes. 

The articulations or joints are of three kinds; 
viz. immovable, mixed and movable. The immov¬ 
able joints are either in the form of a seam 
with processes and indentations interlocked to¬ 
gether, or in the form of a fissure where a thin 
plate of one bone is received in a cleft or fissure 
of another, or in the form of a nail where a 
conical process is fastened into a socket, as the 
teeth are with the alveoli of the jaws. The 
mixed joints are those which allow of but limited 


34 


The Bones of the Skeleton. 


motion, as between the bodies of the vertebrae, 
or spine bones. 

The movable articulations include the majority 
of the joints of the body, and are of four varie¬ 
ties, which are determined by the kind of motion 
permitted in each; the movements permitted 
are the gliding, angular, circumduction, and rota¬ 
tion. 


II. —THE MUSCLES. —THE SKIN. 


The muscles, a fibrous contractile tissue, are 
the fleshy part of the body. They control its 
movements by being connected with the bones, 
cartilage, ligaments and skin, and are divided 
into two kinds which are distinguished by struct¬ 
ural peculiarities and mode of action. One kind 
is red, striated, or striped, and is called voluntary, 
or muscles of animal life ; the other kind is pale, 
or white, and non-striated, and is called involun¬ 
tary, or muscles of organic life. 

The striped muscles or those of voluntary or 
animal life are made up of bundles of minute 
reddish fibres running side by side in the same 
direction inclosed in delicate tissue. These bun¬ 
dles are placed side by side with other similar 
bundles, and a number of them are united into 
larger bundles, and these again into still larger 
until the entire muscle is made up of many 
bundles of parallel fibres marked by transverse 
lines or stripes which run around them in a 
circular direction. The bundles of muscular fibres 
can be separated from each other by careful dis¬ 
section and reduced to finer and finer divisions 

35 


I 


36 The Muscles. — The Skin. 

until they become too small to be seen without 
the aid of a microscope. 

The striped muscles make up the great bulk 
of muscular tissues, and as a rule are capable of 
being put in action and controlled by the will ; 
but occasionally they are subject to • emotional 
and instructive influences in which the will has 
no control. The heart is a muscular organ made 
up of striped muscular tissue, but is beyond the 
influence of the will; the facial muscles of 
expression are controlled more by emotion than 
by will ; and the will has but partial control over 
the muscles of respiration, the muscles of the 
ear and the sphincters — sphincter muscles are 
ring-like and constrict or close natural openings. 

The unstriped, involuntary muscles are composed 
of pale flattened bands or bundles of spindle 
shaped fibres, and are found in the walls of the 
hollow viscera; viz. the trachea, bronchi, stomach, 
intestines, gall-bladder etc. They are not under 
the influence of the will, and their contraction is 
not rapid and does not involve the whole muscle 
as is the case with the striped muscles. 

The membranes, which are composed of the 
unstriped, involuntary muscle, slowly contract a 
part of their extent, usually under the influence 
of mechanical stimulus, and then the contracted 
part slowly relaxes while another part of the 
membrane contracts. What is called the “vermi- 


Muscular Power. 


37 


cular motion ” of the intestines is produced by this 
peculiar action of the unstriped muscles which 
enter into the formation of their walls. ' 

Muscles are so arranged that they give beauty 
to the body as well as strength. Nerves, arteries 
and veins are distributed to them, and they are 
either in a state of active contraction or passive 
relaxation. During contraction they do not become 
either larger or smaller, but increase in thickness 
in exactly the same proportion that they diminish 
in length. 

Most of the muscles of the body and limbs are 
arranged in pairs and act alternately with each 
other, as flexors and extensors, abductors and 
adductors, supinators and pronators, etc. Muscles 
that bend a joint are called flexors, and those 
that straighten it extensors. One is on the ante¬ 
rior or front part of the joint, and the other on 
the posterior or back part. By the alternate con¬ 
traction and relaxation of the two sets of muscles 
the movements of the body are accomplished; but 
should both sets of muscles of a limb act at the 
same instant, the limb would become stiff and 
rigid, and could not move in either direction. 

Muscular power is expended during contraction 
and regained during relaxation, therefore a muscle 
cannot remain contracted during any great length 
of time, but must relax that its force may be 
restored. It is intended in the movements of the 


38 


The Muscles. — The Skin. 


body that the muscles should be constantly chang¬ 
ing from one state to the other, and thus keep 
their natural vigor unimpaired. When there is no 
movement, as when the arm or leg are out¬ 
stretched and kept in one position without 

changing, it is found exceedingly exhausting in 
a short time; while the natural motion of the 

limb a much longer time would not be exhaust¬ 
ing. Standing upright and motionless for the 
same reason, is more tiresome than walking. 

Muscular fibres are constantly inclined to contract 
as is evident from the fact that when the mus¬ 
cles of one lateral half of the face are paralyzed 
the antagonistic muscles always draw the features 
to the other side. The contraction is not 
exhausting in instance of this kind because there 
is no power in the paralyzed muscles to over¬ 
come and the contraction required to draw the 
soft tissues aside is but slight. 

Man, without the aid of the muscles, could not 
stand erect and would be a helpless, shapeless 
mass. When the muscles cease to act, as in 
apoplexy, or in injury to the brain, or nerves 
distributed to the muscles, the head drops upon 
the chest, the spinal column bends forward, the 
arms hang helpless, the lower limbs bend and 
give way at the hip and knee joints, and there 
is general relaxation, prostration, and entire col¬ 
lapse. 


The Number of Muscles. 


39 


Muscles vary in their form, shape and size; 
the stapedius, a small muscle of the internal ear, 
weighs only about a grain, while the gastrocnemius 
muscle forms the chief bulk of the calf of the 
leg; the longest muscle of the body, called sar- 
torius, is nearly two feet in length. 

The total number of muscles in the adult is 
reckoned at five hundred and twenty-seven, of which 
two hundred and sixty-one are in pairs, and five sin¬ 
gle on the median line. The muscles of the head 
and face number eighty-three, of the neck forty- 
nine, of the thorax seventy-eight, of the abdomen 
thirty-three, of the back seventy-eight, of the 
upper extremities ninety-eight, and of the lower 
extremities one hundred and eight. 

The origin of a muscle is its fixed point, and 
its insertion is its movable one, and as its object 
in contracting is to draw the parts to which it 
is attached nearer to each other, both ends of a 
muscle are not attached to one and the same bone. 

All muscles are enveloped in a sheath and 
terminate at one or both ends by rounded cords 
of white glistening fibrous tissue, called tendons 
'or sinews. The tendons are strong and unyield¬ 
ing, and have no contractile power like the 
muscles. There are also shiny, pearly-white, fibrous 
membranes called aponeuroses, which are connected 
with muscles and with bones, cartilages and 
ligaments. 


40 


The Muscles. -— The Skin. 


Muscles have been named according to their 
uses, their position, their shape, their dimensions, 
their direction, their composition and their attach¬ 
ments. The muscle called diaphragm, which acts 
as a partition in separating the cavity of the 
chest from that of the abdomen, and the muscles 
called extensors, flexors, levators, depressors, etc., 
are named according to their uses. The temporal 
muscle, interspinals, etc., are named according to 
their position. The muscles known as trapezius, 
splenius, serratus, digastric, deltoid, scalenus, etc., 
are named according to their shape. The muscles 
pectoralis major and minor, and the maximus, 
medius and minimus, are named according to 
their dimensions. The obliquus, transversalis and 
rectus abdominus muscles are named according to 
their direction. The muscles called semimem¬ 
branosus, semitendinosus, complexus, etc., are named 
according to their composition; and the sterno- 
clidomastoideus, and sternohyoideus muscles are 
named according to their attachments. 

The covering of the human body, the skin, is 
not only for the protection of the deeper tissues, 
but as it is supplied with numerous nerve fila¬ 
ments, it is endowed with exquisite sensitiveness, 
and is the principle seat of the sense of touch; 
and as it has numerous pores or openings which 
give passage to the sweat and other exhalations, 
it is the great regulator of the heat of the body. 


The layers of Skin. 


41 


The skin extends into all the natural open¬ 
ings, and within the body it is called the mucous 
membrane, because it changes its properties and 
becomes soft and moist. The skin on the surface 
of the body is of variable thickness, and is 
usually described as composed of three layers; viz., 
he epidermis or cuticle, the rete mucosum, and 
the derma or cutis vera; the latter being most 
internal, and the sensitive papillae are on its sur¬ 
face, and the sweat glands, hair follicles and 
sebaceous glands are imbedded beneath it. The 
rete mucosum is between the cuticle and cutis 
vera, and is but slightly developed in white races, 
but is very thick and distinct in the negro, and 
its cells are filled with pigment which gives the dark 
color to their skin. The epidermas or cuticle is 
the external part of the skin, and is formed of 
a disorganized scaly substance which is intended 
as a protection, or defensive covering to the sensi¬ 
tive true skin beneath. This is the layer of skin 
raised when a part is said to be blistered. 

The skin is very elastic, and occasionally in 
dropsical and other swellings stretches to enormous 
proportions. 

The hair, nails, sudoriferous and sebaceous 
glands and their ducts are the appendages of the 
skin. 


III. — THE NERVOUS SYSTEM.—ITS 
STRUCTURE. 


That portion of man by which the mind is 
brought into connection with the physical world 

is called the nervous system; its tissue is com¬ 

posed chiefly of two different structures, called 
the gray or vesicular, and the white, tubular, or 
fibrous; they not only differ from each other in 
color, density, and minute structure, but in chem¬ 
ical composition. 

Nervous impressions and impulses are supposed 
to originate in the former, which is of a dark, 

reddish-gray color, and is never found in the 

nerves, but is usually collected in masses, called 
nerve-centres, where it is intermingled with the 
white tubular or fibrous structure. It may be 
seen in the brain, spinal cord and ganglia; the 
latter are knot-like enlargements in the course of 
a nerve. Impressions and impulses are conducted 
by the white, tubular substance, which besides 
entering into the composition of the brain and 
spinal cord, forms almost the whole of the cerebro¬ 
spinal nerves and a great part of the sympathetic. 

The tubular nerve fibres are slender white 


42 


The Nerve Fibres. 


43 


threads or filaments, and are distributed in every 
direction throughout the various tissues of the 
body, reaching every part of the skin, muscles, 
and glandular organs. They are of extreme deli¬ 
cacy, and too small to be seen without the aid 
of the microscope; but as they approach each 
other they unite, side by side, into little bundles; 
as these bundles emerge from different parts, 
they join each other, and these again join others; 
when such a collection becomes large enough to 
be seen by the naked eye, it is called a nerve, 
which is a round or flattened cord distributed at 
one end with the various textures of the body, 
as just mentioned, and at the other connected 
with the brain, spinal cord, or ganglia. 

Nerves in their course from a nerve centre not 
only subdivide into branches, but these frequently 
communicate with the branches of a neighboring 
nerve; and although the fibres which compose a 
nerve become intermixed with those of other 
nerves, in no instance have the separate fibres 
been shown to coalesce; each nerve fibre, like the 
separate threads in a skein of silk, proceeds 
uninterruptedly from its origin to its destination. 

The nervous substance besides being composed 
of two different structures, is again divided into 
two portions or different systems. The first is 
called the cerebro-spinal system, and it includes 
the brain, spinal cord, and nerves proceeding from 


44 The Net vous System. — Its Structure. 

them. This system presides over the locomotory, 
respiratory, sensitive and intellectual functions. 
The second, called the sympathetic system, consists 
of a chain of ganglia extending from the cranium 
to the pelvis along each side of the spinal column; 
nerves with ganglia branch from this system to 
the viscera in the thoracic, abdominal and pelvic 
cavities. 

The sympathetic system presides over those 
organs over which the consciousness and will have 
no immediate control: by means of its numer¬ 
ous communications with the cranial and spinal 
nerves, it is indirectly, but not directly, connected 
with the brain and spinal cord. 

Nerve fibres are bound together, covered and 
protected, by a strong thin transparent membrane 
called the neurilemma or sheath. The white tubu¬ 
lar nerve fibre, and what is called the gelatinous 
fibre, are intermingled in most nerves, the former 
being more numerous in the cerebro-spinal system, 
and the latter predominating in the sympathetic 
system. 

The nerve fibres of both the cerebro-spinal and 
spmpathetic systems are of two different kinds, 
endowed with two different functions, although 
between these two kinds there is no apparent 
difference in their structure. One kind called 
afferent or sensitive fibres, convey impressions from 
without inward ; the other kind called efferent or 


The Brain. 


45 


motor fibres, transmit nervous stimulus from within 
outward. 

When two or more nerves communicate, it forms 
what is called a plexus, in which the component 
nerves divide, then join and again subdivide, in 
such a complex manner that the nerve fibres 
become most intricately interlaced. 

The Brain. All that portion of the nervous 
system within the cavity of the cranium, is called 
the encephalon or brain; it is divided into four 
principal parts, called the cerebrum, cerebellum, 
pons varoli and medulla oblongata. 

The average weight of the whole mass in the 
adult male is about fifty ounces, and in the female 
about five ounces less. It gradually increases in 
weight, in both sexes, up to forty years of age, 
after which it loses about one ounce with each 
ten years. 

The brain is covered, held together and pro¬ 
tected, by three membranes, called the dura mater, 
arachnoid, and pia mater. The dura mater or hard 
mother, is so called because it is a thick, inelas^ 

tic membrane, and is firm and resisting. It lines 

« 

the interior of the cranium and its outer surface 
which adheres closely to the inner surface of the 
cranial bones, is rough, but its inner surface is 
smooth. The arachnoid and pia mater are very 
delicate membranes. The arachnoid, which is 
between the dura mater and the pia mater, is 


46 The Nervous System. —Its Structure. 

called arachnoid because it is like a spider’s web 
in its extreme thinness. The pia mater, or kind 
mother, is so called because it dips into every fold 
and convolution of the brain, and protects and 
supports the organ in every direction. It is the 
innermost membrane and consists of minute plexus 
of bloodvessels held together by a remarkably 
fine areolar tissue. 

The outer surface of the brain beneath the 
membrane, is broken into numerous folds called 
convolutions — there are a countless number of 
little eminences with depressions called sulci 
between them. The outer surface is composed of 
gray nervous matter, and is called the cortex or 
bark; the inner portion is called the medullary 
substance from its white marrowy appearance. 

The cerebrum forms the largest portion of the 
encephalon, and occupies almost the whole of the 
upper and front part of the cranial cavity. It is 
divided by a median longitudinal fissure into two 
exactly corresponding halves, called right and left 
hemispheres, which are connected at their base by 
a white medullary band called the corpus-collosum. 
Each hemisphere is subdivided at its base into 
three lobes, named from their situation the ante¬ 
rior, middle, and posterior lobes. 

The cerebellum, called little brain (its average 
weight in the male being but five and one half 
ounces), is situated beneath the posterior lobes of 


The Spinal Cord. 


. 47 


the cerebrum, and like it is divided into two 
symmetrical halves which are united by a convex 
white body called the pons varolii. 

The pons varolii is a bond of union connecting 
the cerebrum above, the cerebellum behind, and 
at its lower border the medulla oblongata (upper 
part of the spinal cord), which is about an inch 
and a quarter in length; it extends through a 
hole in the bottom of the skull, called foramen 
magnum, which is placed directly over and opens 
into the channel in the spine; at the upper 
border of the first spine-bone the spinal cord 
proper commences. 

The Spinal Cord. The spinal cord extends from 
the brain down the spinal canal to the lower 
border of the body of the first lumbar vertebrae, 
where it terminates in a slender filament of gray 
nervous matter. It occupies in the adult the 
upper two thirds of the spinal canal; its length 
is about seventeen inches. It does not fill the 
spinal canal, and when divested of its membranes 
and nerves, its weight is only one ounce and a 
half. 

The spinal cord is soft and delicate, and is 
composed, like the brain, of white and gray ner¬ 
vous matter; but the gray matter instead of 
forming the outer portion, as in the brain, occupies 
the centre. The white nervous matter constitutes 
the greater part of the cord. 


48 The Nervous System. — Its Structure . 

The spinal cord is covered and protected by the 
same number of membranes that envelope the 
brain, and they bear the same names. In form 
the cord is a flattened cylinder. Two longitu¬ 
dinal median fissures, one in front and the other 
behind, divide it into two symmetrical halves, but 
they are united in the middle, throughout the 

entire length, by a transverse band of white and 

•« 

gray nervous substance called the commissure, or 

. V 

respectively the white and gray commissure. 

The Spinal Nerves. The nerves which issue 
from the sides of the whole length of the spinal 
cord are thirty-one pairs, which number corre¬ 
sponds with the intervertebral foramina through 
which they pass. Eight are called cervical nerves, 
twelve dorsal, five lumbar, five sacral, and one 
coccygeal. Each nerve arises by an anterior or 
motor, and a posterior or sensory root; the latter 
is the largest, and directly after it emerges from 
the membranes which surround the cord, a gan¬ 
glion is developed upon it. None of the fibres 
of the anterior or motor root intermingle with 
the ganglion, although the root lays in contact 
with it; immediately beyond the ganglion the two 
roots are united in one sheath, and their fibres, 
by intermingling, form a compound or mixed nerve, 
which after issuing from the intervertebral canal, 
divide into an anterior and posterior branch, each 
containing fibres from both roots. The nerves in 


Most Important Nerves of the Body. 


49 


their distribution divide and subdivide into various 
branches, from which nerve filaments are sent to 
every part of the body and limbs. 

The anterior branches of the first four cervical 
nerves form the cervical plexus, which is in front 
of the four upper vertebrae, and has both super¬ 
ficial and deep branches, the most important of 
which is the phrenic nerve ; this nerve is formed 
by the third and fourth cervical, and a branch 
from the fifth. It descends to the root of the 
neck, enters the chest, and sends a few filaments 
to the membranes surrounding the lungs and heart, 
then passes down to the diaphragm (the muscular 
partition between the chest and abdomen), which 
it pierces, and is distributed to its under surface. 
The right phrenic nerve is a little shorter than 
the left, but both are distributed to the diaphragm, 
which depends upon them for the whole power 
of motion in respiration. 

The twelve intercostal nerves on each side, 
which, as their name indicates, are distributed to 
the intercostal muscles between the ribs — the six 
lower being also distributed to the walls of the 
abdomen — are the anterior branches of the twelve 
dorsal nerves; they are united with the spinal 
cord from the level of the first rib to that of the 
last. 

Most Important Nerves of the Body. The mech¬ 
anism of respiration consists of the movement of 


50 The Nervous System. — Its Structure. 

the diaphragm, by which the abdomen is protruded 
below, and the movement of the intercostal mus¬ 
cles, by which the chest is raised and expanded 
above. Now as the phrenic and intercostal nerves 
enable the diaphragm and intercostal muscles to 
move in the act of respiration, and as death would 
ensue should they cease to act, these nerves may 
be considered the most important in the human 
body. 

When the spinal cord is injured at the lower 
part of the neck, or the level of the first rib, 
the intercostal muscles are paralyzed and the chest 
will not expand ; therefore a fracture of the upper 
part of the spine is more dangerous than one 
lower down. Although the intercostal muscles do 
not act, death will not ensue, for breathing is 
partially• kept up by the action of the diaphragm; 
but should the neck be broken above the middle 
part, and the spinal cord severed above the third 
vertebrae, death will occur immediately. 

The Brachial Plexits. The Brachial plexus is 
formed by the interlacing of the anterior branches 
of the four lower cervical and first dorsal nerves, 
and extends from the lower part of the side of 
the neck to the axilla or arm-pit. It communi¬ 
cates with the cervical plexus, has branches both 
above and below the clavicle or collar bone, has 
a communicating branch to the phrenic nerve, has 
branches to the shoulder and chest, and sends numer- 


Lumbar and Sacral Nerves and Plexuses. 5 1 

ous branches to supply the arm, fore-arm and hand. 

Lumbar and Sacral Nerves and Plexuses. The 
lumbar plexus is formed by the anterior branches 
of the four upper lumbar nerves, and is located 
in a muscle called psoas. Its branches may be 
divided into two groups, one of which supplies the 
wall of the abdomen, and the other supplies the 
forepart of the thigh and inner side of the leg. 
The roots of the lumbar nerves and upper sacral 
are the largest of all the spinal nerves, and the 
roots of the sacral and coccygeal nerves, on 
account of the spinal cord not extending beyond 
the first lumbar vertebrae, are the longest of all 
the spinal nerves. 

The anterior branch of the fifth lumbar nerve, 
joined with a branch from the fourth, unites with 
the first sacral nerve and forms what is called 
the lumbo-sacral nerve. The sacral plexus is 
formed by this nerve and the anterior branches 
of the three upper sacral nerves and a part of 
the fourth ; the plexus has five branches distrib¬ 
uted to the neighboring tissue, the largest and 
most important of which is the great sciatic 
nerve. 

Largest Nerve in the Body. The great sciatic 
is the largest nerve in the body (it measures 
three quarters of an inch in breadth), and descends 
along the back part of the thigh, dividing at its 
lower third into two large branches. In addition 


5 2 The Net vous System. — Its Structure. 

to supplying the muscles of the back part of the 
thigh, it supplies those of the leg and foot and 
nearly all the integument of the leg. When this 
nerve is affected with neuralgic pain the disease 
is called sciatica. 

The Cranial Nerves. The nerves which arise 
from the nerve centre within the cranium are 
called cranial nerves. They are nine in number 
on each side; they are numbered according to 
the order in which they pass out of the cranial 
cavity, and, like the nerves of the body and limbs, 
those of the right side correspond exactly with 
those on the left. 

Three of the cranial nerves, although classed as 
sensory nerves, are neither sensitive nor motor in 
the ordinary meaning of these terms; and they 
are capable of conveying only the special sensa¬ 
tion characteristic of the organ with which they 
are connected. They are the olfactory, the special 
nerve of the sense of smell, the optic, the special 
nerve of the sense of sight, and the auditory, the 
special nerve of the sense of hearing. 

The olfactory, unlike the other nerves of the 
body, is soft and pulpy in structure ; it contains 
gray matter in its interior, and instead of a nerve 
it may be regarded as a lobe, a ganglion, or a 
part of the brain. From that portion of it known 
as the olfactory bulb are given off about twenty 
nerve filaments, which are distributed to the 


The Cranial Nerves. 


53 


lining membrane of the nose for the purposes of 
conveying odorous impressions to the brain. 

All of the muscles of the eyeball are supplied 
by the third nerve, and the muscle of the eyeball 
called superior oblique is also supplied by the 
fourth, the smallest of the cranial nerves. 

The fifth, the largest of the cranial nerves, is 
called trifacial, because while within the cranium 
it divides into three portions, distributed respec¬ 
tively to the upper, middle and lower parts of the 
face. It is peculiar in having various functions, 
and it is composed of both sensory and motor 
nerve fibres, which form a nerve of sensation to 
the head and face, of motion to the muscles of 
mastication, and of the sense of taste to the ante¬ 
rior part of the tongue. As it supplies the jaws 
and teeth it is a nerve with which dentists should 
be familiar. 

The sixth nerve supplies a muscle of the eyeball 
called external rectus. The seventh nerve is 
divided into the portio dura, hard portion, and 
portio mollis, soft portion; the former is the 
motor nerve of expression in the face, supplies the 
muscles of the external ear, etc., and is called the 
facial nerve; the latter is distributed to the inter¬ 
nal ear and is the auditory nerve, or nerve of 
hearing. 

The eighth consists of three nerves, called glos- 
so-pharyngeal, pneumogastric, and spinal accessory. 


54 The Nervous System. —Its Structure. 

The glossopharyngeal is a special nerve of taste, 
a nerve of motion to the pharyngeal muscles, and 
of sensation to the mucous membrane of the 
pharynx and tonsil. It derives its name from its 
distribution. The pneumogastric is so called because 
it is distributed to the organs contained in the 
chest and abdomen. It has a more extensive dis¬ 
tribution than any other cranial nerve, and its 
fibres are both motor and sensitive. The nerve 
supplies the organ of voice and respiration with 
both of these fibres, and has motor fibres distrib¬ 
uted to the pharynx, oesophagus, stomach and 
heart. The spinal accessory nerve has two por¬ 
tions, one the spinal, and the other accessory to 
the pneumogastric. The ninth, called hypoglossal 
nerve, is the motor nerve of the tongue. 


IV. _ the NERVOUS SYSTEM.— ITS FUNC¬ 
TIONS. 

The nervous system presides over and governs 
the entire body, and whether we are asleep or awake 
all our acts and feelings are through its agency. 

The brain, the great nervous centre, collects and 
preserves impressions for an indefinite length of 
time, as is seen in the remarkable power of mem¬ 
ory, which is an important power, as our actions 
are guided by what has previously taken place; 
without the power of memory life would be a 
blank, a period of idiocy, and our acts capricious and 
unreasonable. 

The intellectual faculties, reason, judgment, mem¬ 
ory, etc., depend upon the quantity and quality of 
brain, but principally the latter. Brains may be 
of the same size and weight, but differ as to qual¬ 
ity. The greater the number of folds or convolu¬ 
tions, and the greater the quantity of gray matter, 
the better the quality of the brain, and more 
superior the intellect. As the gray nervous matter 
is that part of man which enables him to think, 
reason, guide and direct the movements of his 
body, it is the residence of his immortal principal, 

55 


5 6 The Nervous System. — Its Functions. 

his rational, spiritual part, his soul. The eyes and 
face reveal the thoughts, emotions and even the 
most private feelings, and have therefore been 
called “the mirror of the soul.” The expression 
is as true scientifically as metaphorically. 

The brain and nervous system are subject to 
the same law of growth and decay of its atoms as 
govern the other parts of the body. Every 
thought, every mental effort, destroys a certain 
portion of cerebral matter, and when destruction 
takes place more rapidly than renewal, as in exces¬ 
sive study, or over-anxiety, a wasting or softening 
of the brain is the result. For the nourishment 
and restoration of the brain, the removal of old 
Worn-out atoms and the deposit of new and sleep, 
the brain’s natural rest, at certain intervals, is 
required. As the brain is the most active part of 
the body, it requires and receives a much larger 
proportion of blood than any other part. 

The brain gains strength and develops by mod¬ 
erate appropriate exercise; and the mental facul¬ 
ties are developed to a greater or less degree in 
different persons and in the same person at dif¬ 
ferent ages. The brain although the organ of 
sensation, is not itself sensitive ; its substance can 
be cut with less pain than the fingers, but attended 
of course with the greatest danger. The excite¬ 
ment to all muscular motion flows from the gray 
matter of the brain, spinal cord, or a ganglia, 


The Power of the Nerves. 


57 


through the motor nerves to the part that is 
wanted moved. 

Nerves conduct impressions only, and they have 
no more power of generating force or of origina¬ 
ting impulses than telegraphic wires have of 
originating in themselves the messages which they 
transmit. The nervous system and the telegraphic 
system are somewhat similar; the nerves represent 
the wires and the nerve centres the offices, but 
the nerves transmit impressions only in one 
direction. The afferent or sensory nerve fibres 
have the power only of conveying impressions 
from different parts of the body to a nerve centre, 
and are each capable of only one kind of sensi¬ 
bility ; as of touch, sight, hearing, taste and smell, 
and no more than one of these. The efferent or 
motory nerve fibres have the power only of con¬ 
veying impressions from a nerve centre, calling 
into motion or activity the muscles or organs to 
which they are distributed. The rapidity with 
which this is accomplished is described in the 
New York Medical Record , in its issue of October 
15th, 1881, page 423, as follows: 

“The rapidity of nerve-impulses has been quite 
accurately measured, and has long been well known. 
Hirsch’s experiments are also quite familiar, in 
which he showed that a touch on the face was 
recognized by the brain, and responded to by a 
manual signal in the seventh of a second; also 


58 The Nervous System .— Its Functions. 

that the speed of sense differed for different 
organs; the sense of hearing being responded to in 
the sixth of a second, while that of sight required 
only one fifth second to be felt and signalled. In 
all these cases the distance traversed was about 
the same, so the inference is that images travel 
more slowly than sounds or touch. It has still 
remained, however, to show the portion of this 
interval taken up by the action of the brain. Pro¬ 
fessor Donders, by a very delicate apparatus, has 
demonstrated this to be about seventy-five thou¬ 
sandths of a second. Of the whole interval, forty 
thousandths are occupied in the simple act of rec¬ 
ognition, and thirty-five thousandths for the act of 
willing a response. When two irritants were 
caused to operate on the same sense, one twenty- 
fifth of a second was required for the person to 
recognize which was the first ; but a slightly longer 
interval was required to determine the priority in 
the case of the other senses. These results were 
obtained from a middle-aged man, but in youths 
the mental operations are somewhat quicker than 
in the adult. The average of many experiments 
proved that a simple thought occupies one fortieth 
of a second.” 

As a sensory nerve’s only function is to trans¬ 
mit impressions from its extremities to a nerve 
centre, the brain refers all impressions made in any 
part of a nerve’s course to its terminations; for 


Injury to the Nerves. 


59 


instance, when the trunk of a nerve is injured, as 
when the elbow is struck suddenly against a hard 
substance and a nerve pressed between it and the 
bone, a peculiar sharp, tingling sensation is felt in 
the fingers, hand and forearm, where the termina¬ 
tions of the nerve are distributed. The feeling is 
so odd that people usually exclaim, “ Oh, I have hit 
my crazy bone ! ” but it is the nerve and not the 
bone that is injured. The pain of any disease of 
a nerve is felt at its extremities. An example is 
shown in the disease called tic douloureux, which 
is an affection of the trunk of a nerve leading 
from the brain to the face, but the pain is felt 
at the extremities of the nerve on the face. 

After a leg is amputated, should the nerves of 
the remaining stump be irritated, the brain refers 
the pain to the toes, foot, leg, or to whatever part 
the nerves had been distributed. People not 
understanding this have supposed that there was 
some mysterious connection between the separated 
and buried limb and the living body. 

What is called reflex nervous action is a move¬ 
ment executed without consciousness. It consists 
of conveying a sensory impression inward to the 
gray matter of the spinal cord or a ganglia, where 
it is converted into a motor impulse and reflected 
outward. Examples of it are seen when all volun¬ 
tary motion is lost in the lower limbs by the spinal 
cord being severed in the upper part of the back, 


60 The Nervous System .— Its Functions . 

and communication with the brain cut off. 
Although the lower extremities are paralyzed, tick¬ 
ling the soles of the feet will cause twitching of 
the muscles and often slight movement of the 
limb through reflex nervous action. This action 
often takes place in health, but we do not usually 
notice it, because our attention is not attracted 
by a conscious sensation ; but it is important in 
protecting the body from sudden injuries and in 
regulating the action of some of the internal 
organs. ( See Diseases of the Nervous System.) 

• The Five Senses. The five senses, sight, hearing 
smell, taste and touch, have each an organ or surface 
to receive the impression, a nerve to convey it, and 
a sensorial ganglion in the brain to perceive it. 

The sense of sight, hearing and touch, have 
been called the intellectual senses, as they admin¬ 
ister more especially to the intellect; and the 
sense of smell and taste have been termed the 
bodily or nutritive senses, as they are more con¬ 
nected with the nutrition of the body. 

A slight impression may be made upon either of the 
organs of sense while the mind is strongly preoccu¬ 
pied, without our taking cognizance of it; therefore 
to render a sense acute, attention should be given it. 

When the nerves of special sense are irritated, 

* 

touched or diseased, they excite sensations peculiar 
to the organ to which they are distributed; for 
instance, when the optic nerve is injured, an im- 


The Sense of Sight. 


6 1 


pression of light is conveyed to the brain, and not 
pain. Probably everybody has, at some period of 

their life, “seen stars,” as it is expressed, after 

% 

receiving a fall, or blow, in which this nerve has 
been injured ; or should the blow be on the side 
of the head, and an impression made on the 
auditory nerve, a ringing in the ears is produced. 
The roaring noise heard when the end of the finger 
is introduced into the ear, is caused by the circula¬ 
tion of blood in the finger. In certain diseases, 
patients complain of a bad taste in the mouth, 
and wash and purify it without avail, because the 
disagreeable taste is caused by a disturbance or 
derangement of the nerve of the special sense of 
taste. 

The Sense of Sight. The sense of sight has for 
its organ the eye, lodged for its safety in a cavity 
or socket called the orbit, which has been described 
in connection with the skull. 

The eyeball is composed of two fluids called 
humors, a crystalline lens, and three tunics or 
coats; the latter retaining the organ in its glob¬ 
ular shape. The outer coat is formed by the scle¬ 
rotic and cornea. The sclerotic is a firm, strong 
membrane which covers the entire globe, excepting 
about a fifth part in front, which is covered by 
the smooth, transparent cornea. The middle coat 
is formed by the choroid, iris and ciliary processes, 
the latter being formed by the folding inward of 


62 The Nervous System . — Its Functions. 

certain parts of the former. The choroid is a thin 
vascular membrane,* and its internal surface is coated 
with a dark brownish secretion called the nigrum 
pigmentum, which absorbs such rays of light as 
are not needed for vision. The iris, a continuation 
of the choroid coat, is of various colors in different 
individuals, therefore its name iris, a rainbow. It 
is a delicate circle with an aperture, the pupil, for 
the transmission of light in the centre. 

The amount of light received into the eye is 
regulated by the expansion and contraction of the 
iris. - When we go from a bright light into the 
dark we see with difficulty, because the iris is 
expanded and the pupil is so small that but few 
rays can enter the eye ; but soon the iris contracts, 
the pupil enlarges, more rays are admitted, and we 
see more clearly; but too much light enters the 
eye and dazzles it when suddenly entering a very 
bright place from a dark one; but soon the iris 
expands, the pupil diminishes, fewer rays enter, and 
we see without inconvenience. The third or inner 
coat of the eye is the retina, on which the images 
of objects are impressed. The retina is principally 
the expansion of the optic nerve, which conveys 
impressions of sight to the brain. The refracting 
media of the eye is the aqueous humor, a clear, 
transparent fluid separated by the iris into an 
anterior and posterior chamber, but communicating 
through the pupil; the crystalline lens enclosed 


The Sense of Sight. 


63 


in its capsule which lies behind the posterior 
chamber; and the vitreous humor which fills the 
cavity of the retina behind the crystalline lens 
forming four fifths of the entire globe. 

The eyes appear larger in some persons than in 
others, but in reality there is but little difference 
in their size; but they are not as deeply set in 
their sockets, and the lids open wider in some 
persons than in others. 

Each eyeball has six small, slender muscles in¬ 
serted in their outer coat, and attached at the other 
end to the bony socket. They carry the eye through 
all its motions. Where one of these muscles act 
more powerfully than its antagonist, it draws the 
eye one side, and the person is said to be cross¬ 
eyed. 

The appendages of the eye are the eyebrows, 
eyelashes, eyelids, conjunctive and lachrymal appa¬ 
ratus. The eyebrows and eyelids moderate the 
action of the rays of light in their passage to the 
eye, and protect the organ from insects and minute 
bodies. The eyelids protect the eye from injury 
by their closure. The upper is the larger and 
more movable of the two lids. They both are 
lined by the conjunctiva, which is a thin mucous 
membrane also continued over the front of the 
eye, and as it is kept moist it allows the lids to 
glide freely and smoothly over the ball. There 
are about thirty small glands on the inner surface 


64 The Nervous System. — Its Functions . 

of the eyelids, the ducts of which have minute 
openings on the free margin of the lids. The use 
of their secretion is to smear the edges of the eye¬ 
lids and prevent their adhesion, and also prevent 
the tears running over the lids; their relation to 
each other being similar to oil and water. 

The lachrymal gland, at the upper, outer of the 
orbit which secretes the tears, and its excretory 
ducts which convey the fluid to the surface of the 
eye, comprise the lachrymal apparatus. 

The tears are spread over the surface of the eye 
five or six times a minute by the act of winking, 
and thus wash it and keep it clean and moist. ^ 
The fluid is then collected at the inner corner of 
the eyelids, and carried away by the lachrymal 
canals into the lachrymal sac, and through the 
nasal duct into the cavity of the nose. The lach¬ 
rymal gland is sensitive to mental emotions, and 
by the sympathetic action of the nervous system 
is frequently excited to increased activity, and the 
tears which are discharged in excessive quantity 
being too abundant to be influenced by the secre¬ 
tion of the glands of the eyelids, run over their 
edges and trickle down the cheeks and face. 

The Sense of Heaiing. The organ of the sense 
of hearing, the ear, has been described in connec¬ 
tion with the temporal bone, and it is supposed 
that the reader is familiar with the machinery by 
which this function is performed. 


The Sense of Smell. 


65 


Sound is produced by the vibration of the atmos¬ 
phere, and hearing is the sense by which sounds 
are perceived. Air is set in motion by the voice, 
the ringing of a bell, or any other cause, and 
comes in waves or undulations, and is collected 
by the auricle, the external ear, and the vibrations 
are transmitted ’ to the internal ear, where it comes 
in contact with the filaments of the auditory nerve, 
and conveyed to the brain. 

The Sense of Smell. The organ of the sense of 
smell, the nose, consists of an external and internal 
part — the nose and nasal fossae; the latter having 
been described in connection with the skull. 

The nose is a pyramidal eminence covering the 
nasal fossae, occupying the upper middle part of 
the face between the forehead and upper lip, the 
eyes and the cheeks. The nose is formed of 
bones, cartilage, fibro-cartilage, muscles, vessels 
and nerves. 

The mucous membrane lining the nose, called 
the Schneiderian or pituitary membrane, receives 
the impression of odors by means of the expansion 
of the olfactory nerves upon that portion of it 
in the upper and middle part of the nostrils. 
The lower part of the nasal passages have no 
sense of smell, but are provided with ordinary 
sensibility, and feel the contact of solid bodies, 
sharp and irritating vapors, and feel sensations of 
cold, heat, itching, tingling, etc. 


66 The Nervous System. — Its Functions. 

That the sense of smell and common sensation 
are distinct is proven by the fact that when the 
sense of smell is lost ordinary sensation still re¬ 
mains. 

The nose is not only the organ of smelling, but 
serves as a passage for the air in breathing, and 
has an influence on the voice. The short stiff 
hairs in the openings of the nose are intended to 
prevent the entrance of particles floating in the 
atmosphere. The nose forms one of the charac¬ 
teristic features of the human face, and has been 
regarded as a reliable index of character, and is 
the one feature above all others that confers 
either attractiveness or repulsiveness to the coun¬ 
tenance ; but people’s views differ as regards 
beauty. 

The sense of smell besides adding to our pleasur¬ 
able sensations directs us in the choice of food, 
warning us to avoid putrid and dangerous substances, 
and also warns us to avoid breathing a foul and un¬ 
healthy atmosphere. 

The Sense of Taste. The organ of the sense of 
taste, the tongue, is a soft, fleshy viscus, movable 
in every direction. Its movements are subservient 
to speech, and the prehension and swallowing of 
food. The upper surface of the tongue is covered 
with numerous projections or eminences called 
papillae, and in each lateral half of the tongue are 
distributed three nerves, which give the organ the 


The Sense of Touch . 


67 


power of motion and common sensation besides 
the sense of taste. 

Taste may be cultivated to a high degree of 
delicacy, and its use is not only to give pleasure 
in eating and drinking, but to guide in the selection 
of food; and it also excites the flow of saliva 
and other secretions by which the food is prepared 
for the digestive process. 

The Sense of Touch. The skin, already described, 
is the principle seat of the sense of touch, the 

simplest and most extensively diffused of all the 
senses. 

The sense of touch in certain parts, as the tongue, 
fingers, lips, soles of the feet, etc., is more acute 
than in others. The sense gives us information 

of the softness or resistance of bodies, of their 

shape, smoothness or roughness, of their fluidity 
or solidity, and of cold, heat, etc. 


v. — THE VASCULAR SYSTEM. 


The arteries, capillaries, veins and lymphatics are 
the four classes of vessels which in addition to 
the central organ, the heart, comprise what is 
called the vascular system. 

The Heart and Circulation of Blood. The heart, 
a hollow muscular organ of conical form, the 
blood’s reservoir, is enclosed in a membranous sack 
called pericardium, and placed between the lungs 
obliquely, in the lower front part of the thorax, 
inclined most to the left side. Its average length 
in the adult is five inches, breadth three and one 
half inches at broadest part, and its thickness two 
and one half inches. 

Males have larger hearts than females. In the 

former its weight varies from ten to twelve 

ounces, and in the latter from eight to ten ounces. 

The organ continues to increase in size and weight, 

especially in men, up to an advanced period of 

life. The interior of the heart is divided into four 

cavities called the right and left auricle, and the 

right and left ventricle. The right auricle is 

larger than the left, and the left ventricle is larger 

68 


The Heart and Circulation of the Blood. 69 

than the right. The right auricle holds about two 
ounces, and receives through two large veins the 
dark venous blood from the entire body. 

The vein through which the blood from the 
upper half of the body enters the right auricle, 
is called superior vena cava, and from the lower 
half of the body, inferior vena cava. The blood 
which nourishes the heart itself is returned to 
the right auricle through what is called the coro¬ 
nary sinus. 

The dark venous blood passes from the right 
auricle into the right ventricle, and from the right 
ventricle it passes through the pulmonary artery 
into the lungs, where it becomes arterialized, or 
purified, by receiving oxygen from the air. Its 
color is then changed to a bright scarlet, and it 
passes through the pulmonary veins to the left 
auricle, from which it passes to the left ventricle; 
from the left ventricle it passes into the aorta, 
the largest artery of the body, and through its 
subdivisions is distributed throughout the entire 
body for nutrition, preservation of life, generation 
of heat, and the secretion of the different fluids. 

The blood expends its vital and constructive 
properties in its journey through the body, and 
becomes dark colored and impure; it is then 
called venous blood. 

The capillaries collect the blood distributed by 
the arteries, and the veins return it from all 


70 


The Vascular System. 


parts of the body back to the two large veins 
already mentioned, which return it to the right 
auricle of the heart. This complete passage of 
the blood constitutes its circulation. 

The openings both of entrance and exit of the 
heart, as well as the openings between the auricles 
and ventricles through which the blood passes, are 
guarded by valves. 

The contraction and relaxation of the heart 
constitutes what is called its pulsation. The action 
of the arteries, called the pulse, corresponds with 
that of the heart, and is effected by the contrac¬ 
tion of their muscular and great elasticity of their 
external coat. The blood leaves the heart when 
it contracts, and enters when it relaxes. 

The Arteries. The arteries, the cylindrical elas¬ 
tic canals, which serve to convey the blood to 
every part of the body, were named arteries by 
the ancients because they supposed that they 
contained. 

The name artery was first given to the trachea, 
or windpipe, which conveys the air to the lungs, 
and afterwards the same name was given to the 
arteries because nothing but air is found in them 
when opening a dead body—the blood collecting 
in clots. 

Galen, who flourished in the second century, was 
the first physician who showed that they contained 
blood in the living body; but Harvey, an English 


The Arteries. 


71 


physician, was the first who discovered that the 
blood circulated. The discovery was made in the 
seventeenth century. 

The aorta, the main arterial trunk, commences 
at the upper part of the left ventricle, and after 
ascending about two inches arches back over the root 
of the lungs, and descending on the left side of the 
vertebral column, it passes through the diaphragm; 
opposite the fourth lumbar vertebrae it terminates 
in the right and left common iliac arteries. It 
is divided into the arch, the thoracic and abdom¬ 
inal aorta. 

The distribution of the arteries throughout the 
body is like a highly ramified tree; the aorta 
the trunk in the centre, and the branches in 
every part of the body excepting the nails, hair,, 
epidermis, cartilages and cornea. Larger arterial 
branches or trunks usually occupy protected sit¬ 
uations, and in the divisions of arteries a short 
trunk occasionally subdivides into several branches 
at the same point, or the vessel may give off 
several branches in succession and still continue 
as the same trunk. The division between them, 
however, is usually dichotomous, as, for instance, the 
aorta dividing into two common iliacs. 

Arteries that freely communicate with each 
other form what is called an anastomosis or inoscu¬ 
lation ; this occurs where great freedom and 
activity of the circulation is required, as in the 


72 


The Vascular System. 


brain, around the joints of limbs, etc. The larger 
arterial branches throughout the body pursue a 
perfectly straight course, but in certain situations, 
as in the arteries of the face and lips, they are 
tortuous and accommodate themselves to the move¬ 
ments of the parts. 

From the ascending part of the aorta are given 
off two small arteries called coronary, which con¬ 
vey blood to nourish the heart; from the transverse 
portion of the arch are given off three arteries 
called arteria innominata, left common carotid, and 
left subclavian. The arteria innominata, the largest 
but shortest of these branches, is about two inches 
in length, and divides into the right sub-clavian 
and right common carotid. The common carotid 
arteries on each side branch into the external and 
internal carotid arteries. Eight branches are given 
off from the external carotid which are the superior- 
thyroid, lingual, facial, occipital, posterior auricular, 
ascending pharyngeal, temporal and internal maxil¬ 
lary, distributed as indicated by their names. 
The internal carotid passes up in the cranium, 
pierces the dura mater, and supplies the front 
portion of the brain and the eye and its appen¬ 
dages. 

The sub-clavian artery, so called because it is be¬ 
neath the clavicle or collar bone, extends to the outer 
border of the first rib; its continuation to the outer 
border of the axilla or arm-pit is called the axillary 


The Arteries . 


73 


artery; and its extension to the bend of the elbow is 
called the brachial artery. At the elbow the brachial 
artery divides into the radial and ulnar arteries, which 
with their branches supply the forearm and hand. 
There are four branches of the sub-clavian artery, 
seven of the axillary, and five of the brachial. Those 
of the radial are twelve, and of the ulna nine, which 
are divided into three groups : those of the forearm, 
wrist and hand. The largest and most important 
branch of the sub-clavian is the vertebral artery 
which passes up through foramina in the transverse 
process of the six upper vertebrae, and enters the cra¬ 
nium, where it unites with the opposite vertebral and 
forms the basilar artery at the base of the brain. 
The vertebral gives off two branches in the neck and * 
four within the cranium. The anastomosis at the 
base of the brain between the basilar artery and 
branches of the internal carotid, form what is 
called the circle of Willis. 

The thoracic aorta give off pericardiac, bronchial, 
oesophageal, posterior mediastinal and intercostal 
branches distributed as indicated by their names. 

The abdominal aorta after giving off branches 
to the internal viscera and walls of the abdo¬ 
men, is divided into the right and left common 
iliac arteries. The internal iliac with its branches 
supplies the viscera and walls of the pelvis, 
the generative organs, and the inner side of the 
thigh. The external iliac is larger than the inter- 


74 


The Vascular System. 


nal in the adult, and is the chief vessel which 
supplies the lower limb. It gives off several 
branches, and its continuation down the thigh is 
called the femoral and popliteal, both of which 
have several branches. The popliteal divides into 
the anterior and posterior tibial arteries, which, 
with their branches, supply the leg, ankle and foot. 

The Capillaries. The capillaries, or capillary 
vessels, so called from their hair-like minuteness, 
are the connection between the extremities of 
the arteries and the veins, carrying blood from 
one to the other in every part of the body. 
They are too small to be seen with the naked 
eye, but it is in them that the carbonization of 
blood is effected, the animal heat produced, and 
from them that the bile, sweat and urine are 
secreted. 

The capillaries inosculate with each other in 
every direction, and form an interlacing network, 
or capillary plexus, as it is termed. The walls of 
the capillaries are exceedingly thin and delicate > 
and the ingredients of the blood necessary for 
the nourishment of the organs and tissues of the 
body, slowly transude through them, and are 
absorbed in such proportion as is required. 

The Veins. The veins are continuous with the 
minute capillaries, and as they approach the heart 
they unite into larger and fewer tubes, until at 
last they terminate in the two large veins pre- 


The Veins. 


7 5 


viously mentioned, through which is conveyed the 
blood from the upper and lower half of the body 
into the right auricle of the heart. 

The veins are larger, more numerous, and 
their capacity is greater than the arteries. They 
do not pulsate like the arteries, and the blood 
flows through them more slowly; they have 
valves which allow the blood to pass toward the 
heart and prevent it flowing backward. They 
communicate very freely with each other, and 
are divided into three sets : superficial, deep 
and sinuses. 

The superficial or cutaneous veins return the 
blood from the skin and fascia and communicate 
with the deep veins by perforating the deep fascia. 

The deep veins are enclosed in the same 
sheath with the arteries, and usually accompany 
the smaller arteries, as the radial, ulnar, brachial, 
tibial and peroneal, in pairs, one on each side. 
Only one vein usually accompanies the larger 
arteries, as the axillary, sub clavian, popliteal, and 
femoral. The deep veins do not accompany the 
arteries in certain parts of the body, as in the 
skull, spinal canal, hepatic veins of the liver and 
the larger veins returning blood from the bony 
tissue. Sinuses are venous channels found in 
the interior of the skull, formed by a separation 
of the layers of the dura mater. 

The Portal System. The portal system is com- 


76 


The Vascular System . 


posed of four large veins which collect the blood 
from the small veins proceeding from every part 
of the bowels and the membranes that surround 
them. The four veins unite and form one large 
trunk called the vena portae, or portal vein, 
which enters the liver and divides and subdivides 
till it is diffused over the substance of the 
gland in the most minute ramifications. The 
blood thus brought to the liver is the darkest 
and most impure in the system, but it is 
charged with the nutritious materials from the 
viscera of digestion. As it passes through the 
liver it is subject to the action of certain secret¬ 
ing vessels which separate from it much of its 
carbon and other impurities, and forms a new 
substance called bile. At the capillary termina¬ 
tions of the portal vein are formed the three 
hepatic veins which carry the blood from the 
liver to the inferior vena cava. 

Systemic and Pulmonic Arteries and Veins. 
The arteries which convey the blood from the 
left ventricle of the heart throughout the body, 
and the veins which return the blood from all 
parts of the body to the right auricle of the 
heart, are the greater, systematic or systemic 
arteries and veins, and the blood circulating- 
through them is called the systemic circulation. 

The pulmonary artery which conveys the blood 
from the right ventricle of the heart to the lungs, 


The Lymphatics. 


77 


and the four pulmonary veins which return the 
blood from the lungs to the left auricle of the 
heart, belong to the pulmonic or lesser system, 
and the blood circulating through this system is 
called the pulmonic circulation. 

The Lymphatics. The lymphatics are delicate 
transparent vessels containing a fluid called lymph 
from its resemblance to water; hence the name 
of the vessels, lymphatics. As they absorb cer¬ 
tain materials from the tissues and convey it 
into the circulation, they are also called absorbent 
vessels. They have been found in nearly every 
part of the body excepting the substance of the 
brain, spinal cord, cartilages and tendons, and are 
arranged into a superficial and deep set. The 
superficial accompany the superficial veins on the 
surface of the body, and by perforating the deep 
fascia join the deep lymphatics, which are larger 
than the superficial, fewer in number, and accom¬ 
pany the deep bloodvessels. 

The lymphatics are smaller than the veins, but 
they exceed the veins in number, and their anas¬ 
tomoses, especially those of the larger vessels, are 
more frequent. In the course of the lymphatic 
vessels, but more especially in the neck, axilla, 
groin and abdomen, are found numerous small 
glandular bodies called lymphatic or absorbent 
glands, through which the lymphatic and lacteal 
vessels pass. The lacteal vessels are the lym- 


78 


The Vascular System. 


phatic vessels of the small intestine, called lacteal, 
because during digestion they absorb and carry 
into the circulation the chyle, a milk-white nutri¬ 
tious fluid. These lacteal vessels together with 
the lymphatics coming from the stomach, liver, 
spleen, kidneys, loins, and those passing into the 
abdominal cavity from the legs and thighs, empty 
into a single tube or duct called thoracic, which 
extends from the second lumbar vertebrae to the 
root of the neck, and terminates at the angle of 
junction of the left internal jugular and sub¬ 
clavian veins, where it empties into the circula¬ 
tion. 

The thoracic duct commences in the abdomen 
by a triangular dilatation called the receptaculum 
chyli, and the length of the entire duct varies 
from eighteen to twenty inches. All the lymphat¬ 
ics of the left side of the head, neck, and entire 
left side, as well as all those of the lower part of 
the body and limbs, empty into the thoracic 
duct. The lymphatics of the right arm, right 
side of the head, neck, thorax, right lung and 
right side of the heart empty into the right 
lymphatic duct, which terminates at the angle of 
union of the right sub-clavian, and right internal 
jugular veins, into which it empties. 

The openings both of the thoracic and right 
lymphatic duct into the veins are guarded by 
valves which prevent blood entering the ducts; 


The Lymphatics. 


79 


and the lymphatics in all parts of the body, like 
the veins, are provided with valves. 

The lymphatics absorb and carry away in the 
form of lymph those ingredients of the tissues 
which have become useless and need purifying. 
The lymph finds its way to the thoracic and 
right lymphatic ducts and through them into the 
veins where it becomes intermingled with the 
venous blood. It is renovated and restored with 
the blood by its passage through the heart and 
lungs before it again takes part in the functions 
of life. 

The arteries carry to a part blood purified 
by receiving oxygen from the air in the lungs, 
and they deposit fresh nutritious matter, while 
the veins and absorbents carry away the impure 
blood and old worn-out material; thus the human 
body is undergoing a constant change. These 
two sets of vessels are equally active during the 
middle period of life. The arteries carry and 
deposit sufficient nutritious matter to build up 
the body as fast as it is worn out and carried 
away by the veins and absorbents ; but during 
the early period of life and the period of growth, 
more nutritious matter is brought and deposited 
by the arteries than is taken away by the 
veins and absorbents. 

When the lymphatics are excessively active and 
absorption predominates the body wastes away, 


8 o 


The Vascular System . 


becomes lean and diminishes in weight; but 
when the arteries deposit more nutritive matter 
than is taken away, the body grows fat, plump, 
and increases in weight. 

Exercise causes a waste of old atoms of flesh 
and increases the demand for new; it causes an 
increased quantity of food to be eaten and 
digested so that the blood may receive more 
chyle and thus supply the demand for an increased 
amount of nutritious matter. The active growing 
youth and the laborer therefore require more food 
than the indolent or aged. 


VI.—ADIPOSE TISSUE OR FAT. 


Adipose tissue or fat consists of a number of 
vesicles or sacs, each one composed of an extremely 
delicate transparent membrane forming a closed 
cavity in which the oily matter is contained. 
These vessels are held together by capillary blood¬ 
vessels and fine connective tissue. 

Adipose tissue is found in nearly all parts of 
the body, but in certain localities more abundant 
than others; it gives that roundness and plumpness 
to the body which imparts symmetry and beauty 
to the appearance. In the decline of life when it 
is absorbed, hollows, cavities and wrinkles, so antag¬ 
onistic to beauty, are left. 

Adipose tissue acts as a soft and delicate cushion 
to certain parts, which if left unprotected would 
be exposed to injury or inconvenience; it also 
serves to retain the warmth of the body; therefore 
those persons who are thin and emaciated suffer 
more from exposure to cold than those provided 
with adipose tissue. Adipose tissue in addition to 
its other uses, adds to the specific lightness and gives 
elasticity to the body and assists in keeping it from 
sinking in water 

81 


82 


Adipose Tissue or Fat. 


Fat is fluid in the living, but solid in the dead 
body. Although a certain amount of fat is really 
necessary to the well-being of the body, it is 
sometimes generated in such quantities that the 
body assumes that state of corpulence called obesity, 
which is a diseased condition in which there is 
so much fat that it interferes with the healthy 
functions of the body and it becomes sluggish 
and unwieldy. 

The amount of adipose tissue necessary to health 
varies with the climate — hot climates require less 
than cold; therefore nature to a certain extent 
regulates itself in this respect, for in most persons 
adipose tissue is diminished in summer and increased 
in winter. (See Man’s Stature and Weight — Their 
Relation to Health.) 


VII. —THE BLOOD. 


The blood, the most important fluid of the body, 
is assisted in supplying the body with nutrition 
by the lymph, chyle, saliva, gastric-juice, bile, and 
intestinal secretion. 

The blood in the arteries is always of a bright 
scarlet, while that in the veins is always of a dark- 
red color; the same blood is constantly changing 
color in the circulation and is alternately bright 
scarlet and dark-red as it passes from one set of 
vessels to the other. 

Water, albumen, fibrine and mineral substance 
enter into the composition of the blood and are 
its most important ingredients. (See Morbid States 
of the Blood.) After blood is taken from the 
body and allowed to stand it soon separates into 
two parts; one is a fluid called serum, and the 
other is the clot or coagulum; the latter is due 
to the fibrine. When a bloodvessel is cut or injured 
the fibrine by coagulating stops the flow of blood; 
but if the injury is severe it requires assistance 
in the form of compression, styptics, or a ligature. 
(See Hemorrhage.) 


83 


8 4 


The Blood. 


The quantity of blood in a living healthy body 
is about one eighth part of its weight ; therefore 
a man weighing one hundred and sixty pounds has 
about twenty pounds of blood; but the quantity 
and composition of blood varies somewhat at dif¬ 
ferent times. After digestion it has absorbed the 
nutritious materials from the food, which must pass 
through the blood to reach the tissues, and the 
quantity of blood, therefore, at such times is 
increased. 

As a rule no harm results from the loss of a 
small quantity of blood, but the loss of a pound 
usually causes faintness. The loss of two pounds 
is followed by complete unconsciousness, and if a 
much larger quantity is lost recovery is impossible ; 
but if the bleeding is stopped the patient usually 
recovers. Where the vital powers are nearly 
exhausted by extreme loss of blood, life may be 
restored by an operation called the “transfusion 
of blood,” which consists of injecting in the patient’s 
bloodvessels healthy blood from another person. 

When blood is examined under the microscope, 
red and white corpuscles are seen floating in the 
fluid; the red being the most numerous. As 
human blood corpuscles differ in appearance from 
those of animals, the microscopic examinations of 
blood stains has furnished important evidence in 
murder trials. 


VIII. —THE ALIMENTARY CANAL.—THE 
SALIVARY GLANDS. 


The musculo-membranous tube from thirty to 
thirty-five feet in length, extending from the mouth 
to the anus, is called the alimentary canal; it is 
divided into different compartments or cavities which 
communicate with each other by narrow orifices. 

The mouth at its commencement is the cavity 
in which mastication, the mechanical division of 
food, and insalivation, its admixture with a fluid 
called saliva, takes place. The organs of deglut¬ 
ition, the pharynx and oesophagus then convey the 
food into a second cavity, the stomach, in which 
it comes in contact with the gastric juice, and in 
which the reduction and solution of food, and its 
principal chemical changes occur. Then comes 
the small intestine from twenty to twenty-five 
feet in length, divided into three portions; the 
duodenum, the jejunum and ileum. In the duode¬ 
num are found the orifices of the biliary and 
pancreatic ducts. 

The food becomes mixed with the bile and 
pancreatic fluid in the small intestine, and the chyle, 
the nutritious principle of food, is separated from 

85 


86 


The Salivary Glands . 


that portion which passes into the large intestine, 
most of which is expelled from the system. The 
large intestine, about five feet in length, is sep¬ 
arated from the small intestine by the ileo-caecal 
valve, and is divided into three portions: the caecum, 
colon and rectum; the latter being the lower 
portion, six or eight inches in length, terminating by 
the anus, at which is situated a double sphincter 
muscle for the purpose of guarding the orifice. 

The Salivary Glands. The fluid by which the 
mouth and tongue are constantly moistened in 
their natural state is called the saliva. It is color¬ 
less, tasteless and odorless, and is poured into the 
cavity of the mouth by the parotid, submaxillary 
and sublingual glands. 

The paroted is the largest and the sublingual the 
smallest of the three glands. The former derives 
its name from being placed near the ear, and the 
latter from its being beneath the tongue. The 
submaxillary is situated at the inner side of the 
ramus and body of the lower jaw bone. 

The saliva keeps the mouth moist at all times, 
but chewing excites it to flow in larger quantities. 
An inflammation of the parotid and submaxillary 
glands, of a contagious or epidemic origin, is called 
parotitis or mumps. 


IX.—THE LIVER.—THE PANCREAS. 


The liver, the largest gland in the body, weighs 
from three to four pounds. It is situated in the 
upper part, and chiefly on the right side of the 
abdomen. In a state of health its upper border 
is about two fingers’ breadth, or less, below the 
right nipple, and its lower border a fingers’ breadth 
beyond the ribs, below, in front. The organ ex¬ 
tends to the left in the epigastric region, about 
three inches from the middle line, and to about 
midway between the breastbone and navel. It has 
five ligaments, five fissures, five lobes, and five 
vessels. Four of the ligaments are formed of folds 
of peritoneum, and the fifth results from the oblit¬ 
eration of the umbilical vein. The five fissures are 
on the under surface of the liver, and divide the 
organ into five lobes; the right is the largest, the 
left next, and the others are less important. The 
five vessels are the hepatic artery, portal vein, hep¬ 
atic vein, hepatic ducts, and lymphatics. 

The substance of the liver is made up of a 
large number of minute lobules held together by 
an extremely fine areolar tissue ; and of the rami¬ 
fications of the portal vein, hepatic duct, artery 

8? 


88 


The Pancreas. 


and veins, and the lymphatics and nerves; the 
whole covered by a fibrous and serous coat. 

All the biliary ducts of the liver unite and form 
two which, uniting, form the hepatic duct, which 
joins the duct of the gall-bladder, forming what 
is called the ductus communis choledochus, the 
common biliary duct, which empties into that por¬ 
tion of the small intestines called the duodenum. 

The liver secretes between two and three pounds 
of a dark-colored fluid, called bile, every day but 
the largest quantity of bile is secreted during diges¬ 
tion (see The Portal System). The gall-bladder, 
a pear-shaped membranous sac, the reservoir for 
the bile, lies under the liver, and holds a little over 
one ounce. (See Gall-stones.) The liver in addi¬ 
tion to secreting bile, transforms a part of the 
nutritious materials received from the blood into 
sugar, which is absorbed by the blood-vessels, and 
passes upward to the heart into the circulation. 
(See Diseases of the Liver.) 

The Pancreas , a conglomerate gland, similar to 
the salivary glands, is situated near, and a little 
behind the lower border of the stomach. It is six 
to eight inches in length, one inch and a half in 
breadth, and from half an inch to an inch thick. 
Its body tapers toward the left extremity, where 
it terminates at the spleen. The pancreas secretes 
a fluid resembling saliva, called pancreatic juice, 
which passes through a duct, and enters the small 
intestine where it assists in the digestion of food. 


X.—ALIMENTATION. 


Alimentation, the act of nourishing, includes after 
taking food, mastication, insalivation, deglutition, 
digestion, absorption, assimulation, and the result 
of these nutrition. 

Mastication and Insalivation. Mastication and 
insalivation are accomplished together. The food 
is chewed, tidtuated and divided in the mouth, and 
at the same time thoroughly moistened with saliva. 
Imperfect mastication causes indigestion, therefore 
it is necessary that it should be properly performed 
that digestion may be easily accomplished. The 
saliva by mixing with the food assists mastication 
deglutition and digestion. 

Deglutition. After food is masticated and insal¬ 
ivated it is forced by the muscles of the tongue 
and palate through the fauces, and over the epi¬ 
glottis into the pharynx; the constrictor muscles 
of the latter forcing it into the oesophagus which 
contracting propels it downward into the stomach. 
This constitutes deglutition, or the act of swal¬ 
lowing. 

Digestion. After food has been trituated and 

89 


9 o 


Alimentation. 


softened in the mouth, it is necessary that it 
should undergo a process of digestion or lique¬ 
faction before it can be taken into the blood. 

The stomach is composed of two principal parts 
— a muscular coat and a lining membrane. When 
food enters the stomach it stimulates the muscular 
coat to what is called peristaltic action, which 
keeps the food in motion and carries it around 
by a kind of churning movement. The presence 
of food, and the motion of the muscular coat, 
causes a fluid called gastric juice, which is an 
acid solution containing pepsine, to be poured out 
from the lining membrane of the stomach, like 
sweat from the skin of the body. The gastric 
juice becomes thoroughly mixed with the food and 
assisted by the peristaltic action of the stomach 
dissolves it and converts the albuminous substances 
into albuminose. The starchy and oily ingredients 
are dissolved in the stomach but otherwise remain 
unchanged. They, together with the albuminose, 
mixed with the gastric juice, form a fluid called 
chyme, which passes out of the stomach into the 
intestine, where the bile, pancreatic juice, and 
intestinal secretion, complete its digestion. The 
fatty, oily ingredients are changed by the pancre¬ 
atic juice into an emulsion, a milky looking fluid, 
called chyle, and the starch is converted into 
sugar by the mixed intestinal secretions. 

While the food, mingled with the digestive 




Digestion — A b sorption. 


91 


fluids, is undergoing digestion, it is carried slowly 
downward by the peristaltic action of the intes¬ 
tine’s muscular coat; and as fast as it becomes 
thoroughly digested, liquefied, and converted into 
materials fit for absorption, it is taken up from 
the intestine’s lining membrane, by the vessels, and 
carried into the circulation. 

The indigestible matter, together with the refuse 
of the intestinal secretions — the remains after 
absorption of the nutritious materials — gradually 
acquire a firmer consistency as the fluids have 
been absorbed and are discharged from the intes¬ 
tines in the form of feces. 

The time required for digestion varies with age, 
temperament, the condition of the stomach, the 
article of food and the way it is cooked, (see 
Different Kinds of Food and their mode of 
Preparation.) That digestion may be properly 
performed, food should be taken only when the 
appetite craves it, at regular intervals if possible, 
and it should be properly cooked, thoroughly mas¬ 
ticated, and both the mind and body should be 
free from any unusual or unpleasant excitement 
during the process. (See Facts and Fallacies 
Concerning Eating and Drinking. ) 

Absorption. The digested fluids, the solution of 
albuminose, of sugar, and the milky looking chyle, 
are absorbed partly by bloodvessels and partly by 
the lacteals. That portion absorbed by the 


92 


Alimentation. 


bloodvessels is carried away with the circulation, 
and that taken up by the lacteals, which is the 
chyle, pass through the mesenteric glands and 
then through the thoracic duct into the circula¬ 
tion. 

The force by which certain fluids are impelled 
through the substance of animal membranes is 
called osmosis ; when they transude from within 
outward exosmosis, and from without inward 
endosmosis. These actions take place in absorp¬ 
tion. 

Assimilation. The act by which the body appro¬ 
priates the digested fluids and transforms them 
into its own substance is called assimilation. 

The nutritive elements are first mingled with 
the blood, and after undergoing certain changes 
are distributed to all parts of the body, each organ, 
structure or tissue, drawing, or assimilating, the 
materials fitted for its growth and support, choos¬ 
ing the molecules identical with its own nature. 

Assimilation may be modified in the progress 
of its work by various circumstances ; it may be 
retarded, rendered active, or changed in its direc¬ 
tion, as is seen in certain diseases when nutrition 
is almost entirely arrested, and in others when 
certain tissues change their nature. Assimilation 
does not take place with the same rapidity in all 
parts of the body, for certain parts increases more 
rapidly than others. 


Nutrition . 


93 


Nutrition. This is the final result of the pre¬ 
ceding acts described under the head of alimen¬ 
tation. Some writers use the word nutrition to 
express all the actions by which composition and 
decomposition are accomplished in the body, 
including under the head digestion, absorption, 
respiration, circulation, assimilation and excretion; 
but nutrition is a term that should be applied 
more especially to the direct appropriation of the 
nutritious parts of the blood to the building up 
of the various parts of the body ; and in this 
sense comprises formation, growth, development 
and repair. Formation in embryonic life, growth 
and development, until maturity, after which the 
only result of nutrition is repair of the parts of 
the body destroyed in active or passive waste, 
disease or injury. 

That healthy nutrition may be affected, it is 
necessary that there should be a sufficient supply 
of blood of good quality, a proper supply of 
nerve force and functional exercise, with appro¬ 
priate intervals of repose. 


XI. —THE SPLEEN. 


The spleen is a ductless gland near the left 
extremity of the stomach, opposite the tenth 
and eleventh ribs. It is oblong, flattened, rounded, 
and of a dark bluish-red color. Its size and weight 
varies under different conditions and at different 
periods of life; its weight in a healthy adult 
varies from four to ten ounces. It is small in 
half-starved individuals, decreases in weight in 
old age, but is large in the glutton, and increases 
in size during digestion. In certain fevers it 
becomes enlarged, and sometimes weighs from 
eighteen to twenty pounds. 

The uses of the spleen are not exactly known. 
It is probable that its function is shared by 
other glandular organs, for it has been removed 
from animals without producing any permanent 
injury other than to excessively develop tne 
appetite, and cause an unnatural ferocity of 
disposition. 

The ancients regarded it to be the seat of 
anger and melancholy; hence the terms spleeny, 

spleenful, etc., applied to persons of a cross and 

94 


Use of Spleen. 


95 


ugly disposition; but modern investigation has 
shown that the nervous system is at fault in 
hypochondria, and in those who have a grouty, 
fretful disposition. The spleen probably assists 
in the formation of blood. 


XII.—LARYNX OR ORGAN OF VOICE.— 

THE TRACHEA. 


The larynx, the organ of voice, situated at the 
upper part of the air passage, is shaped like a 
triangular box, and is formed by nine cartilages. 
The thyroid, the largest cartilage, has a prominence 
especially in men, called Adam’s apple, from a 
notion that it was caused by the apple sticking 
in the throat of our first parent. 

The vocal cords are two elastic bands of fibrous 
tissue in the upper portion of the internal cavity 
of the larynx. The upper opening of the larynx 
is termed the glottis, and it communicates with the 
pharynx, the upper part of the passage leading from 
the mouth to the stomach. 

The glottis is completely covered over during the 
act of swallowing by a thin, leaf-like lid of fibro- 
cartilage, called the epiglottis. During the act of 
breathing the epiglottis is directed vertically upward, 
and air is freely admitted to the passage leading 
to the lungs. 

The larynx, in opening and closing the glottis, is 

moved by numerous muscles, and during deglutition 

96 


Action of Larynx When Taking Food. 97 

it is drawn up beneath the base of the tongue (as 
can be felt by placing the fingers on “ Adam’s 
apple”) which closes the epiglottis backward over 
the glottis, and prevents the food and drink enter¬ 
ing the air passage, but allows it to pass through 
the pharynx and oesophagus into the stomach; 
still, a sudden inspiration, taken as in laughing or 
talking, at the same instant food is swallowed, 
will sometimes permit a small particle to get 
between the vocal cords, and pass down in the 
larynx; the sensitive lining membrane then becomes 
irritated, and the muscles are excited to spasmodic 
efforts of coughing, which usually expels the sub¬ 
stance. 

When the sound of the human voice is pro¬ 
duced, the vocal cords are drawn together, tightly 
stretched, and as they are elastic they are thrown 
into vibrations by currents of air passing from the 
lungs, which is the “wind box,” so to speak, of the 
larynx. The tongue, palate, lips and teeth take part 
in articulation, which is as necessary as voice, in 
speech. As the vocal cords are more or less tightly 
stretched, and as the orifice of the glottis is narrower 
or wider, the note sounded by the voice is high or 
low, acute or grave. 

The Trachea or air tube, commonly called wind¬ 
pipe, is formed of cartilaginous rings and an elastic 
ligamentous membrane. Its length is about four 
and one-half inches, and diameter, which is greater 


9 8 


The Trachea. 


in males than females, is about one inch. It extends 
from the lower part of the larynx to opposite the 
fourth dorsal vertebras, where it divides into the 
right and left bronchi — one for each lung. The 
two bronchi are divided into smaller branches, called 
the bronchial tubes, which continue to separate 
into smaller branches and ramifications, constructed 
similar to the trachea; but when the branches 
become very minute they have no cartilaginous 
rings and are entirely membranous. These small 
branches terminate in innumerable air cells in the 
lungs, which communicate with each other 'and 
give the lungs a spongy appearance. The air passes 
from without through the nostrils and mouth, the 
larynx, trachea, bronchi, and successive divisions of 
the bronchial tubes, and reaches the air cells in 
the lungs. (See Respiration.) 


XIII.— THE LUNGS. 


The two lungs are large conical-shaped vascular 
organs weighing about forty-two ounces, and occu¬ 
pying the greater part of the cavity of the chest. 
They are separated from each other by the heart, 
large bloodvessels, and the two layers of plurae 
— the membrane which surrounds them. The plurae 
forms a space in the median line called mediastinum. 

Males have larger lungs than females, and the 
right lung is larger than the left. The substance 
of the lungs is soft, light, porous or spongy, and 
on the walls of the aircells the blood circulates 
in a network of capillaries and is purified by 
receiving oxygen from the inspired air. 

The lungs, perhaps, are more liable to disease 
than any other part of the body, owing to the fre¬ 
quent variations in temperature of the air inhaled, 
their highly organized structure, and their inces¬ 
sant exercise. (See Diseases of the Organs of 
Respiration and Circulation.) 

Respiration. The alternate inspiration and expi¬ 
ration of atmospheric air is called respiration, or 
the act of breathing. Its object is to bring the 
air in contact with the blood, that the blood may 

99 

> 




100 


The Lungs. 


become arterialized or renovated by giving off car¬ 
bonic acid with the expired air and receive oxygen 
from the inspired air. 

The movements of respiration are accomplished 
as follows : The intercostal muscles elevate the 
ribs, which expands the chest, and takes the pres¬ 
sure from the outside of the lungs, and the dia¬ 
phragm is depressed by its own contraction, and 
the chest is thus enlarged in all directions; at 
the same time the air enters the mouth or nostrils 
and rushes through the air passages and fills the 
cells in the lungs. This constitutes the act of 
inspiration. It is immediately followed by expi¬ 
ration, which does not require any positive effort 
of muscular contraction, for the weight of the ribs 
causes them to fall and the elasticity of the dia¬ 
phragm makes it ascend; the lungs are thus com¬ 
pressed and the air is expelled. (See Most Impor¬ 
tant Nerves of the Body.) 

Prof. Dunglison in his Dictionary of Medical 
Science says: “In the healthy condition the respi¬ 
ration is easy, gentle, regular, and without noise. 
In man, the respirations are generally about thirty- 
five per minute in the first year of life; twenty- 
five during the second; twenty at puberty and 
eighteen in the adult. 

“The air of respiration has been divided into 
first , the residual air ; or that which cannot be 
expelled from the lungs, but remains after a full 


Respiration. 


IOI 


and forcible expiration, estimated at one hundred 
and twenty cubic inches ; secondly , the supplementary 
or reserve air , or that which can be expelled by a 
forcible expiration, after an ordinary outbreaking, 
valued at one hundred and thirty cubic inches; 
thirdly , the breathy or tidal or breathing air, valued 
at twenty-six cubic inches; and fourthly , the com- 
plementajy or complemental airy or that which can 
be inhaled after an ordinary inspiration, which 
amounts to one hundred cubic inches. This esti¬ 
mate gives two hundred and fifty cubic inches as 
the average volume of air which the chest contains 
after an ordinary expiration.” 

The atmosphere is a mixture of oxygen and 
nitrogen — four fifths by weight of the latter to 
one fifth of the former—-but it also contains car¬ 
bonic acid and watery vapor in small quantities 
which vary with the locality and temperature. 

Air is decomposed when brought in contact with 
the blood in the lungs, and its oxygen unites with 
the blood while its nitrogen is returned by expira¬ 
tion, unchanged, with an additional quantity of car¬ 
bonic acid gas and watery vapor. The increase of 
carbonic acid may be shown by breathing into clear 
lime-water, to which it gives a milky turbidness; 

4 

the vapor or water in the breath is made known by 
its condensing in a cloud near the nostrils or mouth 
when in the open air on a cold day. 

The blood which is distributed to the lungs is 


102 


The Lungs. 


that which has circulated through the various parts 
of the body, and rendered unfit by various influ¬ 
ences during its flow for the support of vital 
energy. It has served for the nutrition of the vari¬ 
ous organs and tissues, and is of a dark crimson 
or purple color. After it enters the lungs it gives 
off carbonic acid and absorbs oxygen from the air- 
vesicles, and is instantly changed to a brilliant 
scarlet color. The blood when it leaves the lungs 
is, therefore, entirely different in its appearance 
and properties than when it enters them. (See 
The Blood and Pure Air—Its Necessity.) 

Animal Heat. Animal heat is the result of a 
chemico-vital process ; or, in other words, it is the 
result of the chemical changes of nutrition going 
on in the body. The oxygen, which is carried by 
the blood to all parts of the body, combines with 
carbon and hydrogen in the little capillary vessels, 
forming carbonic acid and watery vapor, which is 
expelled with the breath. The process is a form of 
combustion in which the waste matter of the body 
is the fuel. 

The temperature of the interior of the body is 
about ioo° F.; under the tongue it is about 99 0 F.; 
in the axilla about 98° F.; and in the folds of the 
skin in the palm of the hand about 97 0 F. Chil¬ 
dren have a temperature two or three degrees 
higher. In certain diseases, as scarlet fever, yel¬ 
low fever, typhoid fever, etc., the temperature of 


Animal Heat. 


103 


the body is increased, and in certain other dis- 
eases, as cholera, etc., it is diminished. 

The temperature of the body is regulated by 
the perspiration, and in health remains the same 
in winter and in summer, in the torrid and in 
the frigid zones ; still the thinner and more ex¬ 
posed parts, as the ears, nose, fingers, etc., may 
be cooled down below the standard temperature, 
and may be congealed if the cold is severe. 
Although the temperature of the blood and internal 
organs remains the same as long as the body is 
in a state of healthy activity, should the exposure 
to cold be so great and long-continued that the 
loss of animal heat is more rapid than its produc¬ 
tion, the temperature of the blood begins to fall 
and the individual becomes gradually torpid and 
insensible in proportion as the warmth of the body 
diminishes, and death finally results. 

During the winter months we eat more fatty 
food than in the summer, and people inhabiting 
very cold countries consume large quantities of 
fatty and oily substances, the carbon and hydrogen 
of which are probably required for the production 
of the necessary heat of the body. Animal heat 
is prevented from being dissipated by clothing which 
has no warmth in itself, but is a protection from 
cold, because of its non-conducting property. 


XIV.—THE URINARY ORGANS. 


Two secreting organs, the kidneys, one receiving 
organ, the bladder, two connecting tubes, the ure¬ 
ters, between the springs and the reservoir, and 
one outlet or canal, the urethra, comprise the 
urinary organs. 

The Kidneys. The two kidneys are situated in 
the lumbar region, one on each side of the spine, 
extending from the eleventh rib to near the crest 
of the ileum. They are retained in their position 
by the vessels which pass to and from them. 

Each kidney in the adult is about four inches 
long by two in width, and one in thickness; the 
weight of each varies from four and a half to six 
ounces in the male, and about half an ounce less 
in the female. They are surmounted by the supra¬ 
renal capsule and surrounded by fat. They are of 
a brownish-red color and are covered by a firm, 
thin, transparent, cellular envelope, and are com¬ 
posed of an exterior or corticle substance, and an 
interior or medullary substance. 

The corticle substance forms about three fourths 

of the kidney, and is the seat of the greater part 

104 


The Kidneys. 


105 


of the secretory process. It is made up of a great 
number of uriniferous tubes convoluted and inos¬ 
culating with each other; scattered through the 
plexus formed by these tubes and bloodvessels, are 
dark points called Malpighian (after their discoverer) 
bodies These bodies are convoluted masses of 
minute bloodvessels included in flask-like dilatations 
of uriniferous tubes forming a close relation be¬ 
tween the circulating and secreting systems. The 
medullary substance is denser in structure and 
darker in color than the corticle, and consists prin¬ 
cipally of tubes passing nearly straight inward to 
the central receptacle of the secretion. 

The kidneys drain the system of superabundant 
water, and next to the lungs are the great organs 
of purification for the blood which is constantly 
passing into them through the renal arteries which 
come directly from the aorta. The arteries after 
entering the kidneys, divide into minute branches, 
and the blood undergoes a change as it passes 
through the Malpighian capillaries; the superfluous 
water and some saline bodies — the waste and ex¬ 
hausted materials — are separated from it, after 
which it is returned to the circulation by means of 
a vein which terminates in the ascending vena cava. 
After the water is strained from the blood it is 
conveyed by the uriniferous tubes into what is 
called the pelvis of the kidney. (See Diseases of 
the Kidneys.) 


io6 The Urinary Organs. 

The Ureters. The two cylindrical membranous 
tubes, sixteen to eighteen inches in length, and 
of the diameter of a goosequill, which conveys the 
urine from the kidneys to the bladder, are called 
ureters. 

The ureter on either side proceeds from the pel¬ 
vis of the kidney, of which it is the continuation, 
and descending through the abdomen to the base 
of the bladder, into which it opens by a constrict¬ 
ed orifice, after -passing obliquely for nearly an 
inch between its muscular and mucous coat. The 
entrance of the two ureters are about two inches 
apart, and they are so arranged that it is impossi¬ 
ble for the urine to be returned after it once 
passes into the bladder. 

The Bladder. ■ The bladder is a musculo-mem- 
branous reservoir intended for the reception of the 
urine until the accumulation of a certain quantity 
demands its expulsion. It is situated in the pelvis 
behind the pubis, and in front of the rectum in 
the male; in the female the uterus and vagina 
intervenes between it and the rectum. 

The shape, position and relations, of the bladder 
varies in accordance with age, sex, and degree of 
distension of the organ. Its capacity, as a rule, 
increases with age, and is greater in females than 
in males, but is modified in different individuals 
by their habits and the natural exercise of its func¬ 
tions. The capacity of the bladder is changed 


The Bladder .— The Urethra. 


107 


more frequently by disease, than any other cause. 
Long-continued irritation of the bladder may reduce 
it to such a state that it will not contain more 
than a few drops of‘'urine, and on the contrary, 
when its contents cannot be evacuated, it may be 
distended so as to contain an enormous quantity 
Its ordinary capacity may be estimated at a pint, 
or pint and a half. 

The narrow part of the bladder connected with 
the urethra is called its neck or cervix. In the 
male it is surrounded by the prostrate gland, which 
in shape and size, resembles a horsechestnut, and 
secretes a milky-looking fluid. 

The Urethra. The urethra is a membranous canal 
through which the urine passes out of the body. 
Its length is eight or nine inches in the male, and 
about an inch and a half in the female. 


XV.— THE GENERATIVE ORGANS. 


The function of generation is performed by 
means of two sets of organs, belonging to the 
two different sexes, called male and female organs 
of generation; but as this book is intended for 
general reading by all classes of people, the 

writer omits for obvious reasons, an anatomical 
description of them. 

In the generation of animals and plants, as 
well as a human being, it is necessary that two 
cells, called the germ cell and the sperm cell, should 
take part. The process of growth of the new 

being commences in the former, while the latter 
communicates the growing tendency to it. These 
cells are the product of the two different organs 
of generation. 

Reproduction. Reproduction is a term which 

implies the production, growth and development 
of the new germs which make their appearance 
by generation; but is also used to denote those 
processes by which the individual being is devel¬ 
oped and maintained. In the latter sense it com¬ 
prises the result of the ordinary processes of 

nutrition, which is the constant reproduction of 

108 


Reproduction. 


109 


the same tissue, in the same parts, and is the 
means by which the form of the body is main¬ 
tained during life. 

A plant germinates, grows, blossoms, bears fruit, 
withers and dies. An animal or human being is 
formed from a cell which develops into an embryo, 
which in case of a human embryo, becomes a 
child which is nourished and brought to maturity, 
when it may reproduce its kind, after which it 
declines and dies. While individual organisms are 
constantly perishing and disappearing, it is through 
reproduction that the particular kind or species 
remains in existence, and the different races of 
men since the earliest time known, have thus 
remained without any essential alteration. 

Wherever plants or animals exist, they of course 
indicate the previous existence of others belong¬ 
ing to the same species, and if the whole species 
should be destroyed in any particular locality, no 
new individuals can be produced there unless by 
the previous importation of others of the same 
kind. 

Development. Development of a human being 
commences with the earliest organization of the 
embryonic tissues and ends with the complete 
formation of the adult body. 

The period of birth marks only a single epoch 
in a constant series of changes. The writer will 
not describe those changes which precede birth, 


110 


The Generative Organs. 


but will commence with the new-born infant, 
which is very far from having arrived at a state 
of complete development. 

The general condition of the infant at birth, 
the condition of the skeleton, spinal column and 
skull, are described by Professor Dalton in his 
treatise on Physiology and Hygiene for schools, 
families and colleges, as follows: 

“The weight of the newly-born infant is between 
six and seven pounds. The head and arms are 
larger, and the pelvis and lower extremities 
smaller, in proportion to each other, than in the 
adult. The legs are curved inward at their lower 
part, so that the soles of the feet are not 
horizontal, but look obliquely inward toward each 
other. Even if the infant were strong enough, 
therefore, it could not walk, since the feet would 
not rest upon the ground by their soles, but by 
their outer edges. Both arms and legs also are 
habitually curled upward and forward over the chest 
and abdomen, and are not easily straightened. 

“ The skeleton at birth is soft and yielding, being 
composed to a great extent of cartilage. Some 
of the bones have already begun to show them¬ 
selves in the interior of these cartilages ; but they 
are nearly all small and delicate, and many of them 
are still cartilaginous throughout. The bony parts, 
however, continue to enlarge at the expense of the 
cartilage, until at the end of some years after 


Development. 


hi 


birth, the whole has been converted into the tissue 
of bone. This gradual change of the parts from 
the cartilaginous to the bony condition is called 
the ossification of the skeleton. 

“At birth each bone of the spinal column con¬ 
sists of three separate pieces ; viz., one in front 
of the spinal cord, and one on each side behind 
it. These pieces are, of course, connected with 
each other by cartilage, and thus envelop the 
spinal cord with a series of soft and elastic rings. 

“The bones of the skull are very thin and flexible, 
and their edges are not yet united with each other. 
The skull of the infant, therefore, is not a firm and 
solid case like that of the adult, but rather an 
elastic bag, formed of separate plates, held together 
by the skin and fibrous membranes. A remarkable 
peculiarity of the skull at this time is that there 
are two openings in the bony parts, one at the 
back and one on the top of the head, where the 
brain is only covered by the skin and other soft tissues. 
These openings are called the fontanelles , because 
we can feel the pulsations of the brain through 
them, like the bubbling of water in a fountain.” 

As the bony parts around the fontanelles become 
developed, the openings gradually diminish in size, 
and at the age of four years after birth are com¬ 
pletely closed. 

Respiration is imperfectly performed for some 
time after birth; breathing through the pores of 




112 


The Generative Organs. 


the skin is more active, but by the lungs less 
so than in later life. The lungs do not fully 
expand at once, and it is several days before the 
air penetrates into all the vesicles of their deeper 
parts. The power of generating animal heat is 
also less than later in life, and the warmth of 
the body should be preserved by soft clothing and 
communicated heat. The skin and alimentary canal 
are extremely delicate and impressible, the functions 
of digestion and nutrition active, and the nerves of 
the special sense of sight, hearing, taste and smell 
are comparatively inactive. The consciousness and 
will are feeble and intelligence dormant, but the 
involuntary and reflex nervous actions are highly 
developed, and nearly all the infant’s actions and 
movements of its limbs are of a reflex nature. 

The nervous system of the young infant is almost 
entirely subservient to the process of development, 
and its time is chiefly occupied with eating and 
sleeping, that it may grow and develop. Although 
milk contains all the materials necessary for the 
nourishment of the infant, as it becomes more fully 
developed and begins to acquire strength, it requires 
food in greater variety and in a more solid form. It 
is then that the temporary or milk teeth appear, 
which is a critical period in the infant’s life, owing 
to the nervous irritation produced on the system. 
The eruption of the temporary teeth commences 
about the seventh month and is complete about the 


Development. 


1 13 

end of the second year, when the infant has so far 
developed, increased in muscular strength, and 
bones become so firm, that it can walk without 
assistance. The nervous system gradually becomes 
developed, as the senses are actively occupied with 
surrounding objects, and.the infant learns to under¬ 
stand and speak articulate language. 

The reasoning faculties are slow to develop, and 
the infant as it develops into a child, and even 
while passing through the period of childhood, is 
guided in its actions by instinct and impulses 
rather than reason, which it does not acquire 
until the entire development of the nervous system 
is complete. 

The muscular system and bony skeleton develop 
progressively, and about the seventh year the per¬ 
manent set of teeth begin to appear. The 
period of childhood is followed by that of youth, 
which is manifested by the change of voice and 
growth of beard in the male, and certain changes 
in the female. The development of the body is 
now nearly complete, and in a few years more 
the individual who has passed successfully through 
the different stages of preparation and growth ? 
arrives at maturity, the fully developed adult 
condition. 


XVI.— MAN FULLY DEVELOPED AND 

COMPLETE. 

The fully developed man who enjoys perfect 
health is “complete” as far as his anatomical 
structure is concerned. In his origin he is weak, 
naked and defenceless, and his body no sooner 
arrives at maturity than it begins to decline. 

The anatomical structure of man is peculiarly 
adapted to his well-being during his period of 
existence. None of his bones, muscles, organs or 
tissues could be improved either in their compo¬ 
sition, adaptation to each other, or in their mode 
of action. 

The hands of man are remarkable for the per¬ 
fection of their structure. They are not only 
machines of matchless capabilities, but are instru¬ 
ments of sense — the finger-nails supporting the 
organs of touch without interfering with the 
delicacy of their perception. 

The foot of man is admirably constructed both 
for maintaining the body in the erect posture 
and progression. The sole is broadly expanded to 
support the leg placed vertically above it, and 
the heel is cushioned beneath so as to bear the 
whole weight of the body without inconvenience. 


Powers conferred upon Man. 115 

As man is provided with two hands for prehen¬ 
sion, and two feet for walking, he is called 
bi-manous and bi-ped. 

Man alone of all mamiferous races has con¬ 
ferred upon him the power of articulating sounds,— 
communicating with his fellows by a mode of all 
others the most convenient. The superiority of 
the condition of man over animals is also shown 
in the faculty he has acquired of recording by 
written characters the result of his experience. 

Man has not only obtained dominion over all 
animate creation, but the elements are made to 
serve his purpose, and he enjoys the ability of 
living in almost any part of the globe, in either 
extreme of natural temperature. The African 
negro thrives under the equator, and the Green¬ 
landers and Esquimaux have reached between 
70° and 8o° of north latitude ; but even Amer¬ 
icans and Europeans accustomed to a temperate 
climate can adapt themselves to inhabit either 
of these extremes of heat and cold. Man can 
also subsist on the most varied food. In the 
northern regions the Esquimaux subsist on animal 
food and fish; we enjoy a carefully mixed diet; 
and the inhabitants of the torrid zone live 
chiefly on fruits and vegetables. Probably in each 
case that food which is most universally con¬ 
sumed is that which is best adapted for the 
health of the inhabitants, 


ii 6 Man Fully Developed and Complete. 

Scarcely has the human body acquired its full 
stature and extended to its proper dimensions, 
before it begins to increase in bulk and decline; 
still it is frequently several years after the 
development of the anatomical structure is com¬ 
pleted, before any particular disorder or affliction 
is perceived. The waste and decay although 
gradually progressing, is at first so slight that it 
is not observed. 

Fat accumulates in the cellular tissue, and fre¬ 
quently increases in such quantity that it inflates 
the body, loads it with useless weight, interrupts 
the activity of the muscles, and requires greater 
exertion than formerly to perform the actions of 
life. The increase in bulk is therefore at the 
expense of ease, activity and strength. This is 
one of the first symptoms of the decline of life, 
and the following, taken from Zell’s Encyclopedia, 
will give the reader a clear, correct, and concise 
description of man with his life failing, and 
death approaching: 

“In proportion as we advance in years, the 
bones, the cartilages, the membranes, the flesh, 
the skin, and every fibre of the body, becomes 
more solid, hard, and dry: every part skrinks, 
every motion becomes more slow, the circulation 
of the fluids is performed with less freedom, 
perspiration diminishes, the secretions alter, the 
digestion becomes slow and laborious, and the 


Gradual Dissolution of the Body. nj 

juices no longer serving to convey their accus¬ 
tomed nutriment, those parts may be said to 
live no longer when the circulation ceases. Thus 
the body dies by little and little ; all its functions 
are weakened by degrees ; life is driven from one 
part of the frame to another; universal rigidity 
prevails; and death at last closes the scene. 
When the natural stamina are good, life may 
perhaps be prolonged for a few years by mod¬ 
erating the passions, by temperance, and by 
abstemiousness; but no human art can prolong 
the period of life to any considerable extent. It 
is apparent, indeed, that the duration of life has 
no absolute dependence either on manners, 
customs, or the qualities of particular food; much, 
it is true, is to be ascribed to the quality 
of the air; but we may rely upon it that, if 
luxury and temperance be excepted, nothing can 
alter those laws of mechanism which regulate the 
number of our years. Well may it be said that 
man is a compound being—the link between 
spiritual and animal existence; partaking of both 
their natures, but having also something peculiar 
to himself. His intellectual faculties prove his 
alliance to a superior class of beings; his sensual 
appetites and passions show his affinity to the 
brute creation. A question involving both great 
interests, and difficult of solution, is that of the 
history of Primeval Man.” 






















































PART II. 


MEN AND WOMEN: 

HOW TO SUPPLY THEIR WANTS AND 
DIRECT THEIR POWERS. 




INTRODUCTION. 


E VERY man and woman should know how to sup¬ 
ply the wants and direct the powers of his 
or her own body. Nothing on earth is more impor¬ 
tant to us, and perhaps nothing upon which there 
is a greater diversity of opinion, and nothing upon 
which more carelessness and ignorance prevail. 

If all of the actual physical wants of men and 
women were regularly and completely supplied, and 
their powers intelligently and properly directed, their 
vital, natural and animal functions would be per¬ 
formed easily and perfectly, and there would be 
far less disease, physical pain and mental suffer¬ 
ing in the world than there is to-day. 

There is scarcely any earthly blessing that the 
great mass of people think so little of, and are 
more careless with, than the health of their own 
bodies; but if deprived of health they deeply 
regret its loss, and bitterly complain and reproach 
themselves for their indiscretions. 

The structures and functions of the body have 
certain relations to each other, and to external 
agents, which are most conducive to their well¬ 
being and permanency, and a deviation from the 


122 


Introduction. 


natural and healthy actions of the body, or of any 
individual part, constitutes disease. To prevent 
disease, preserve - health, and prolong life, are the 
objects to be obtained in supplying our wants and 
directing our powers ; and it is necessary in ac¬ 
complishing these ends that we should understand 
the nature of our existence. The moment we 
attempt to penetrate a subject, however, we learn 
that it has depths which we cannot fathom. The 
known is a sign of the infinite unknown. In 
everything, from a grain of sand to the stars, we 
find mysteries before which the knowledge of the 
wisest shrinks into nothingness. All that we can 
do, therefore, is to do the best that we can with 
the facts in our possession. 


I.—WHAT IS LIFE? 


Life, in the general acceptation of the term, 
does not precede birth, but is the time between 
birth and death, in which the body and soul are 
united ; but properly speaking, life commences with 
the first production of the germ, and is that state 
or condition of a being that exhibits vital actions. 
It is manifested in the phenomena of growth, de¬ 
velopment and reproduction, and terminates in the 
death of the organized structure, when its compo¬ 
nent parts are separated and the structure disor¬ 
ganized by the operation of the common laws of 
matter. Life is therefore the sum of the actions 
of an organized being. 

Different Kinds of Force. Vital force or life 
force is a term used to designate that agency in 
organized bodies which gives them the character 
of living beings, and nerve force is a term used 
only to designate the force generated, accumu¬ 
lated, and reflected, by a ganglion or nerve centre, 
and transmitted by nerves. Force is any cause 
which is capable of producing motion in matter, 
or of stopping or altering its direction when pro¬ 
duced. Every particle of matter in creation is 

123 


124 


What is Lifet 


under the influence of several forces, and upon 
which it acts in return. Forces common to all 
nature, as heat, light, electricity, chemical attrac¬ 
tion and gravitation, are called cosmic forces, and 
they have importance in the various functions of 
the body, and are transformed by vital process. 

The action of each particular organ in the 
human body is dependent upon agents external 
to it for the excitation of its properties. Life 
force and nerve force are dependent upon heat, 
light, etc., for their sustenance; and all living 
beings introduce into their own structure alimen¬ 
tary substances derived from external sources, and 
it is necessary that we should breathe and sub¬ 
mit the blood of our bodies to the influence of 
the element which we inhabit. 

When the particular stimulus required by the 
various organs of the body is withdrawn, vital s 
action ceases. 

Correlation and Convertibility of the Forces. The 
doctrine of the correlation and convertibility of the 
forces of nature is very interesting, and a knowl¬ 
edge of it is exceedingly important and indispens¬ 
able in supplying the wants and directing the 
powers of the human body. All forces of nature 
are convertible; assuming either as the cause, one 
of the other will be the effect. Heat will pro¬ 
duce electricity, and electricity heat; magnetism 
will also produce electricity, and electricity mag- 


Correlation and Convertibility of the Forces. 125 

netism, etc., etc. Heat, light, electricity, vital 
force, nerve force, etc., are but different modes 
of motion, and are all mutually convertible. 

No force is ever annihilated. A definite quan¬ 
tity of any one form will produce a definite 
quantity of another. When an organized structure 
dies it is converted into its original chemical ele¬ 
ments, or into something that represents them. 
If a stick of wood is burned, its condition is 
merely changed. It is converted into a definite 
quantity of heat, smoke, gases, watery vapor and 
ashes, which exactly represent the stick of wood, 
and may assist in forming other structures. 

When a human being dies the body is con¬ 
verted into its original chemical elements or into 
something that represents them, as for instance 
the vegetable productions of the earth ; these clear 
away from the earth the elements of the decom¬ 
posing body, and decompose, and assimilate them 
for their own increase. 

The human or an animal body may decay after 
death on the surface of the earth, and the gases 
thus generated will be absorbed by the leaves of 
plants; or the decaying body may be buried deep 
in the soil, and even though out of the absorbent 
reach of the roots of plants and trees, the rain 
finds an easy passage through the soil, and 
trickles upon the decaying body, and from thence 
percolates with portions of the body to the water 


What is Life f 


12 6 

courses in the valley below: it may nourish veg¬ 
etable productions in its passage, or may enter 
into the formation of living objects in the valley. 
It may be said that there is no such thing as 
destruction of life in nature; that there is only 
continual changes in its distribution. 

Man feeds on the lower animals and vegetable 
productions which in due time become a part 
of himself. The lower animals feed upon grasses 
and herbs which, in their turn, become the ani¬ 
mal, then by its death, again pass into the at¬ 
mosphere and are ready once more to be assim¬ 
ilated by plants. This cycle of changes has been 
going on ever since the earth has been formed 
and inhabited ; and it is not difficult to prove 
that the elements of the living bodies of the 
present generation have passed through millions 
of mutations, and formed parts of all kinds of 
animal and vegetable bodies, and consequently it 
may be said that fractions of the elements of our 
ancestors form portions of ourselves. 

The human body, therefore, is not annihilated 
by death, but its condition is merely changed. 
The vital principle, the intellectual, spiritual part, 
known as the soul, is separated from it ; there 
is no vital force or nerve force remaining in the 
previously living structure, and it is in that con¬ 
dition in which waste and decay are not compen¬ 
sated for by repair. As none of the forces of 


Correlation and Convertibility of the Forces . 127 

nature are ever annihilated, but are correlated to 
and persist in each other, it is clear that dur¬ 
ing man’s existence upon earth his animating 
power or part, his soul, is correlated to all the 
other forces of his body and that the Creator 
himself is correlated to his entire creation. 

The ancient Egyptians recognizing the convert¬ 
ibility of the forces of nature, believed that after 
death men’s souls passed into other bodies of this 
or that kind, according to the life they had led; 
and the system of Brahmanism and Buddhism 
represent the soul as passing after death into 
the body of a higher or lower animal as a reward 
of virtue or a penalty for vice. Human life being 
regarded by these ancients only as a link in a 
chain of conditions through which the soul passes 
in a long career of procession from God and 
return to him ; it is perhaps unnecessary to add 
that this theory is founded upon mere supposition. 

There is no evidence of the pre-existence of a 
soul before its appearance in man, but there is 
undoubted evidence of the pre-existence of the 
elements which form his body. It is a well-known 
and established fact, that after the vital principle 
leaves the human body, the matter of which the 
body is composed, enters into the formation of 
other structures ; but what becomes of the intel¬ 
lectual part, the soul, we know nothing other than 
that taught us by the inspired writings. 


II.— WHAT IS HEALTH? 


Perfect health is enjoyed by but few persons, 
therefore health is spoken of as implying merely 
a freedom from actual disease. 

When a man possesses no hereditary taint, has 
a well-proportioned body, calm and regular circu¬ 
lation of the blood, free and full respiration, easy 
digestion, and all his organs and functions are in 
a condition to enable him to bear the “ wear and 
tear of life,” he is called a normal man. 

Although health is defined as “ that state in 
which all the functions of the body are per¬ 
formed with regularity and harmony,” an individual 
may also be in health when certain functions are 
not performed; as, for instance, when a man 'is 
blind. 

The standard of health is not the same in every 
individual. There is a vast difference in men’s 
muscular strength and activity, nervous sensibility 
and sensorial powers, yet all within the limits of 
health, for that is health in some which would be 
disease in others. 

Perfect health, which, theoretically, may be attained, 

is impaired by the influences of the hereditary 

128 


Mail s Stature and Weight. 


129 


impress received before birth, the neglect of san¬ 
itary laws, the friction we undergo in our passage 
through life, and the toil -and anxiety associated 
with existence. The influences imparted by parents 
to their children may to a certain extent become 
neutralized or modified by appropriate training and 
education, still they will ever take a prominent 
part in the formation of individual quality and 
character. It is necessary in the preservation of 
health to be temperate in all things, but espe¬ 
cially in eating, drinking, sleeping and exercise ; but 
before health can be preserved, it must be attained, 
and it cannot be attained, even though other con¬ 
ditions are favorable, unless the height and weight 
of the body are normal. 

Man s Stature and Weight. — Their Relation to 
Health. The height of a human being is seldom 
less than five feet, and rarely more than six; 
females are a little shorter than males. As a rule, 
one fourth the height is reached at birth, one half 
at two and a half years, three fourths at ten years, 
and the full height of the human being is reached 
at the eighteenth year. 

Individuals of medium height usually enjoy bet¬ 
ter health and have a prospect of longer life than 
either very tall or very short persons; but to fix 
the limits at which height and health are incompati¬ 
ble, would be difficult. Short persons, however, have 
a better prospect of health and long life than 


130 


WJiat is Health? 


very tall ones, from the fact that the vital organs 
do not keep pace in development with the muscles 
and bones of individuals exceeding the medium 
height. 

The weight of a healthy man depends upon his 
height and age. A man thirty years of age, five 
feet one inch in height, who is enjoying good 
health, weighs about one hundred and sixteen pounds; 
if his stature should be five feet six inches, he 
would weigh about one hundred and forty-five pounds; 
but if he should happen to be a six-footer, his 
weight would be about one hundred and seventy-eight 
pounds. The increase in weight per inch of stature 
above five feet is usually between five and six 
pounds. 

There are variations in the above figures depend¬ 
ent upon race, employment, habits of life, etc., 
which must be taken into consideration in esti¬ 
mating the standard of health; but when the 
variations are very great, they are usually due to 
some disease lurking in the system. 

A diminution of weight far below the standard 
would indicate impaired nutrition, and an abnormal 
elevation of weight, when manhood is established, 
may imply a tendency to fatty degeneration or 
apoplectic affections. A sudden change of weight, 
especially a rapid reduction, demands more care¬ 
ful attention than an habitual departure from the 
normal standard. It may be caused by some 


Mail s Stature and Weight. 131 

morbid taint that induces wasting, as consumption. 

Normally, there is a progressive increase in the 
weight of an individual from birth to the de¬ 
cline of life. It is not identical with develop¬ 
ment, for the full growth of the body reaches its 
acme in the third decennium of life, and the 
increase in weight after that period, is due to 
the accumulation of fat in various parts of the 
body. Frequently it accumulates in such quan¬ 
tities that it becomes oppressive, uncomfortable, 
and a serious hindrance to life’s activities. It is 
then a diseased condition called obesity. This con¬ 
dition is especially noticeable in a corpulent, help¬ 
less old lager-beer drinker, who is a sort of liv¬ 
ing corpse, so to speak — sickly, wretched, and 
repulsive. 

In some individuals the tendency to an excess 
of adipose tissue or fat is hereditary. The cause 
is some peculiarity of the organism, such as a 
disproportion between the lung capacity and fat¬ 
forming process, which interfers with the proper 
oxidation of ingested material. 

Much has been written on the best method of 
preventing and removing obesity, and the conclu¬ 
sions of most writers are, that the excessive fat 
can be reduced by abstaining from all kinds of 
farinaceous food, sugar and fat ; but much injury 
may arise by the adoption of a disciplinary diet, 
especially when the fat is rapidly reduced in 


132 


What is Health ? 


those who are hereditarily predisposed to it. In 
reducing the weight, therefore, it is best to be 
under the observation of a competent physician. 
Patients who take medicines to remove obesity, 
and at the same time eat heartily of all kinds 
of food, derive but little benefit, and oftentimes 
much harm from the medicine. (See Adipose 
Tissue of Fat.) 

Duration of Life. The length of a man’s life 
depends greatly upon the man himself. Of course 
he cannot prolong his life beyond a certain limit, 
but he can shorten it, and whether he lives one 
quarter, one half, or the full time allotted to 
man, depends principally upon the care he takes 
of his own body. 

Death ought to be a gradual cessation of the 
functions and phenomena of life — the result of 
old age — without pain and suffering, instead of 
the violent, unnatural termination of * existence 
from disease, as is often the case. With certain 
conditions of comfort, moderation, freedom from 
care, regularity of habits and observance of the 
rules of hygiene* the majority of men would live 
their full threescore years and ten; and if they 
have inherited a good constitution from their 
progenitors, may possibly attain the age of one 
hundred. 

As we advance in life we note the survival of 
many of our acquaintances who seemed in boy- 


133 


Duratioii of Life. 

hood and youth quite the reverse of “the fittest," 
while many of those envied in early life for their 
robust health and vigor, are dead. This is due 
to several causes. The man of powerful physique 
and excellent health may violate the laws of 
physical existence every day, and only when a 
long series of follies begin to tell on his con¬ 
stitution, will he comprehend that he has been 
drawing bills on health to be repaid at ninety 
per cent, after thirty, or perhaps sooner. It is 
difficult to convince such a man in his younger 
days, that in seeking pleasure he is constantly 
committing excesses which will shorten his life ; 
that his ambition causes him to overtax his brain, 
nervous system and muscular powers, and that all 
the actions and functions of his mind and body 
should be regulated and properly directed. Al¬ 
though considered a man of sense and pru¬ 
dence, he indulges in those things which expe¬ 
rience proves to be unsuited for him, and he does 
not think of the old saying, that “ A wise man 
governs his passions, but a fool permits his pas¬ 
sions to govern him; ” and in a few years his 
vitality is gone, and his life is prematurely cut off. 

On the other hand there are men who, although 
they have constitutions flawless in point of organic 
disease, lack physical force. When compelled to 
labor excessively, mentally or physically, they are 
quick to feel fatigue, and soon fail from exhaus- 


134 


What is Health ? 


tion. Their grand safeguard is inability to abuse 
their powers. Nature has in their case imposed 
checks too stern to be disregarded, and such 
persons cannot extend their hours of intellectual 
work without pains in the head which positively 
prohibit it. If they drink whiskey beyond mod¬ 
eration, intolerable sickness at the stomach is the 
penalty, and they vomit the spirits out again. 
They have .to be careful whether they want to 
or not, and by compulsorily husbanding their 
resources they often reach eighty, ninety, or one 
hundred years of age, during which time, although 
working moderately, they often accomplish a vast 
and astonishing amount of work. Therefore it 
often appears that the extraordinary- strength and 
good health of some men is a misfortune, and 
the lack of physical force in others is a blessing. 

Some persons appear older at fifty than others 
do at sixty or seventy ; and occasionally a man 

who has reached his hundredth year appears no 

% 

older than one of eighty. The difference in their 
appearance and age is owing to the qualities they 
have inherited, and their mode of life. 

The antediluvians attained an extraordinary age. 
Methuselah who lived the longest, was 969 years 
old when he died. Noah was 500 years old when 
Shem, Ham and Japheth were born; and some* 
of his descendants exceeded what are now con¬ 
sidered the ordinary limits of human existence ; 


135 


Duration of Life. 

still, no one born after the Deluge passed the 
age of 464 years, or one half of that attained by 
some of the antediluvians. Terah, the last who 
exceeded 200, died b. c. 1921, and since his time 
but few instances are recorded of men living 
beyond the term mentioned in the Scripture as 
the ordinary limit of human existence. Buffon, 
a French writer, has offered the following as an 
explanation why the antediluvians attained such a 
great age : “ Before the Flood the earth was less solid, 
less compact than it is now. The law of gravita¬ 
tion had acted for only a little time; the pro¬ 
ductions of the globe had less consistency, and 
the body of man, beiijg more supple, was more 
susceptible of extension. Being able to grow for 
a longer time, it should, in consequence, live for 
a longer time than now.” 

The German Heusler has suggested on the 
same point, that the ancients did not divide time 
as we do. Previous to the age of Abraham, the 
year, among some people of the East, was only 
three months, or a season; so that they had a 
year of spring, one of summer, one of fall, and 
one of winter. The year was extended so as to 
consist of eight months after Abraham and twelve 
months after Joseph. 

The following, which has lately appeared in 
several newspapers, credited to “ Popular Science,” 
throws additional light on the subject: 


136 


What is Health ? 


“ On a full examination of the question of 
patriarchal longevity, the disparity of their ages 
to those of later times disappears. A very slight 
error in the translation of the Hebrew numbers 
has led to all this apparent disparity. The age 
of the antediluvians was not to exceed 120 years. 
Genesis vi., 3: ‘ And the Lord said, My Spirit 

shall not always strive with man, for that he also 
is flesh: yet his days shall be an hundred and 
twenty years.’ This was the regular good old age 
of men, with special variations, both before and 
some time after the days of Abraham. 

“ In reading concrete numbers, the Hebrews 
gave the large number first; thus : ninety and 
seven for 97; forty and seven for 47. The 
reversal of this rule in the translation of Genesis 
v., 3~5> as an illustration, will show the error in 
all similar cases. ‘ Adam lived an hundred and 
thirty years and begat a son,’ etc. This is correct, 
according to the rule. Seth was born when Adam 
was 130 years old, and was his last child. But if the 
rule were here reversed, as it is in the author¬ 
ized version, in the fifth verse, it would read 
thus : Adam lived 3000 years, and begat a son! 
This shocked the consciousness of the Christian 
translator, and he was driven to the true rule of 
the Hebrew uses in case of concrete numerals. 

“ In the fifth verse we have the force of the 
violated rule, thus : ‘ And all the days that Adam 


Duration of Life. 


137 


lived were nine hundred and thirty years : and he 
died ! ’ .A. V. The true reading of the rule would 
be, ‘ And atl the days of Adam which he lived, 
were a hundred years, and thirty and nine years: 
and he died;’ making the entire age of Adam 139 
years, instead of 930 years. 

“ It will be seen on examination, that concrete 
numeral adjectives in Hebrew, as in other lan¬ 
guages, agree in number with their nouns. In 
the case cited in the A. V., the nine is made 
to agree with hundred in the singular, and not 
with years in the plural. The error is seen at 
a glance, for the difference between “ nine years ” 
and “ nine hundred years ” is too great to be 
overlooked in any careful translation of a sacred 
book. The translator assumed that nine here 
agreed with the hundred when it had no such 
agreement; hundred in the text is itself a con¬ 
crete numeral, and separately agrees with years, 
meaning of a hundred years; at the date of this 
writing “ nine hundred,” or any number of hun¬ 
dreds above one, without repetition or circumlo¬ 
cution, there were none of the Masoretic 
points in use. In the case of the age of Terah, 
the father of Abraham, the translators have made 
the attempt to make two hundred out of one 
hundred in the word mathim, used in the plural, 
as it might be to agree with years, thus making 
Terah 205 instead of 105 years old at his 


138 


What is Health f 


t 


death; holding the theory that the word mae 
(or one hundred in the plural, mathim) makes 
twenty. This is contrary to all rule.^ The He¬ 
brews could by pluralizing a numeral less than 
ten, add tenfold to the unit; thus : hemosh, five, 
hemoshim, fifty. This rule, applied in the case 
of Terah, would make him ten times 105 years 
old, or 1050 years old. In the case of Terah 
the historic record conclusively contradicts the 
translation, and hence demonstrates the rule that 
pluralizing one hundred does not in the Hebrew 
tongue make two hundred, while as to the num¬ 
erals between two and ten, the rule might apply ; 
thus : Shelesh, three, sheleshim, thirty, and in a 
like manner to ten. With these corrections, refer 
ing to the ages of the patriarchs before the 
Noachian Deluge, the article of M. de Solaville 
would show a wonderful uniformity in the age of 
man since the dawn of history. 

“ From Adam to the Flood the ages would read 
as in the table below, subject to a few uncertain¬ 
ties in the numbers below 100, as the numerals 
are sometimes pluralized for purposes of agreement 
when they were not increased tenfold. The cases 
are not always certain; the table to the Flood is 
substantially true. The table is added, giving the 
ages of each at the time of his death: 

1. Adam, 130 years, and not 930 years. 

2. Seth, 121 years, and not 912 years. 


139 


Duration of Life. 

3. Enos, 114 years, and not 835 years. 

4. Cain, 119 years, and not 910 years. 

5. Mahalaleel, 122 years, and not 825 years. 

6. Jared, 117 years, and not 962 years. 

7. Enoch, 114 years, and not 365 years. 

8. Methuselah, 124 years, and not 966 years. 

9. Lamech, 117 years, and not 777 years. 

10. Noah, 159 years, and not 950 years. 

Average 120 plus years.” 

There is every reason to believe that in pro¬ 
portion as the laws that effect health are under¬ 
stood and acted upon, the duration of life will be 
increased, and healthier parents will give birth to 
healthier children from generation to generation. 


III.— HOW TO SUSTAIN LIFE AND PRE¬ 
SERVE HEALTH. 

To sustain the life and preserve the health of 
the human body, certain external agents are neces¬ 
sary. A healthy man apparently remains the same 
from day to day, and presents the same unaltered 
aspect of form and size for-a long period of time; 
still he is undergoing an incessant change. The 
various parts of his body are wasting away every 
day, every hour, and every moment, but the struc¬ 
ture appears the same because the tissues and 
fluids are reproduced by means of certain external 
agents, and when these agents are withdrawn, 
health is destroyed and life ceases. 

The food and drink consumed by man, heat, 
light, atmospheric air, etc., are agents by means 
of which his health is preserved and life sustained; 
but out of about sixty elementary bodies only a 
small proportion enters into the composition of 
man and are required to be present in his food 
and drink. Those absolutely necessary are carbon, 
oxygen, hydrogen, nitrogen, sulphur, chlorine, phos¬ 
phorous, sodium, potassium, calcium, magnesium. 

iron and fluorine; but these simple bodies must 

140 


Necessary Elements of Food and Drink. 141 

be in combination before they are capable of being 
assimilated and converted into tissue, and their 
assimilation depends upon certain chemical decom¬ 
positions and physiological processes. There is a 
difference in the number of elementary substances 
in combination. Water, for instance, contains two 
elements; oxygen and hydrogen. Sugar, starch, 
fat, etc., each contains three elements. Caseine of 
milk contains five elements, and albumen and 
fibrine each contains six elements, etc. 

In infancy, childhood and youth, the reception 
of matter exceeds the loss, and the body steadily 
increases in weight; but in old age reparation does 
not keep pace with decay, and the bodily weight 
steadily declines. In the intervening period of 
adult life there is a state of equilibrium; the 
various ingredients of the body are destroyed and 
renewed with but little variation. 

The demands of the body for matter from with¬ 
out at all periods of life are pressing and momen¬ 
tous. If oxygen is withdrawn for but a few 
moments from the air inhaled, suffocation and 
death quickly follow. If food and drink contain¬ 
ing the elements necessary to sustain life are 
withheld, indescribable agonies ensue, the waste 
and decay of the body are not repaired, and life 
becomes extinct. 

Hunger and thirst proclaim that more nourish¬ 
ment is required for bodily support, and the 


142 How to Sustain Life and Preserve Health. 

irresistible demand cannot be put off unless at 
the expense of health and life. Animal and 
vegetable food, together with vegetable gluten, 
contain albumen, fibrine and caseine, which furnish 
the body with oxygen, hydrogen, nitrogen and 
carbon. Meat, eggs, milk, corn, and various vege¬ 
table productions, contain one or more of these 
principles. Food containing sugar, starch, or 
organic acids, introduce carbon, hydrogen and 
oxygen into the system. Fatty foods, nuts, 

etc., contain carbon with a little oxygen and 
nitrogen. 

The body is supplied with phosphorous when 
animal flesh, fish, oysters, etc., are consumed, 

and it also receives it in the shape of phos¬ 

phates, which exist in the juices of many edible 
vegetables. Iron, sulphur, chlorine and sodium 

are introduced into the system in combination 
with various foods ; but the two latter in the 
shape of chloride of sodium (common salt), is used 
to flavor nearly all kinds of food. Potassium and 
calcium are found in various kinds of animal and 
vegetable food; the latter is also obtained from 
drinking water, which usually contains sulphate 
and carbonate of lime in solution. Magnesium 
is usually found with calcium, and traces of 
fluorine exists in blood, milk, etc. The bulk of 
the human body and of the food we eat is com¬ 
posed of carbon, hydrogen, oxygen and nitrogen ; 


Pure Air—Its Necessity. 


143 


but as already stated, all of the elements men¬ 
tioned are essential to health and life. 

Should man be deprived of either one of the 
substances necessary to nutrition, he would die; 
for the other ingredients of the food, although 
proper, are not sufficient by themselves. Medical 
men, in the interest of science, have tried the 
experiment of depriving themselves of one partic¬ 
ular necessary ingredient of food, and found that 
although they consumed the other substances with 
relish for a time, the deficiency soon became 
manifest in the intense craving for the missing 
ingredient. They became feeble, emaciated, and 
would have died of imperfect nutrition, had the 
experiment not been stopped. Therefore, experi¬ 
ence, physiology, and our natural appetites, show 
that man must have a mixed diet; that all the 
substances necessary 'to life must be combined, 
or our food and drink will not be capable of pre¬ 
serving health and sustaining life. 

Pure Air—Its Necessity. Of all the wants of 
the human body, none are so constant and press¬ 
ing as that of air. The demands for food and 
drink may be met by occasional supplies, but air 
must be furnished every moment, or life will 
become extinct. If we desire physical strength 
and energy, it is as important that the air we 
breathe should be pure, as it is necessary that 
the food we eat should be wholesome, How 


144 How to Sustain Life and Preserve Health. 

air sustains life has been explained under the 
head of Respiration. 

Air, or the atmosphere, is a mixture of oxygen 
and nitrogen, in the general proportion of four 
fifths by weight of the latter, to one fifth of the 
former; but it also contains a small quantity 
of carbonic acid and watery vapor, which varies 
with the locality and weather, and which are 
considered as accidental ingredients, and not con¬ 
stituent parts. 

Oxygen is absolutely indispensable to existence, 
but nitrogen neither supports nor destroys life ; 
it dilutes the oxygen, and thus makes it espe¬ 
cially adapted to our existence and well being. 
If we should be confined in a room where there 
is less oxygen than that naturally contained in 
the air, there is a depression of mind and body 
corresponding with the deficiency; on the other 
hand, if the natural quantity of oxygen be 
increased, there is unusual activity of all the 
bodily functions ; the life forces are exalted, and 
the vital operations are driven at a preternatural 
speed. If pure oxygen is respired, life would be 
excited to such a high degree that we would 
rush through its feverish course in a very short 
time. 

Carbonic acid when inhaled is very destructive 
to animal life, but it is the great source of 
nourishment to vegetable life, Animals would 


Pure Air—Its Necessity . 


145 


soon exhaust the oxygen in the air, and supply 
its place with carbonic acid and die, were it not 
for plants; they absorb the carbonic acid from 
the atmosphere under the influence of sunlight, 
and replace it with oxygen through innumerable 
pores in their leaves; thus the proportion of 
carbonic acid in the atmosphere is kept down to 
the point of safety for animals. 

The respiration of animals is not the only source 
of carbonic acid. The great sources of it are, the 
combustion of burning bodies, fermentation and 
decay, and it is poured into the air in vast quan¬ 
tities from volcanoes, springs, etc. When it is set 
free too rapidly to become diffused through the 
atmosphere, it causes suffocation and death to all 
who inhale it. Frequently it accumulates in mines, 
cellars, rooms, wells, etc. ; and as it extinguishes 
flame and suffocates animals, miners call it “ choke 
damp.” 

The atmosphere surrounds our globe and revolves 
with it, and extends from forty to fifty miles from 
the earth’s surface. It has a blue tinge in large 
masses. The distant hills appear blue because 
seen through several miles of air, and the sky 
appears of the same color from the same cause. 

The atmosphere becomes contaminated with sub¬ 
stances detrimental to health and fatal to exist¬ 
ence in many different ways. It is the reservoir 
into which all volatile matters escape; and the 


146 How to Sustain Life and Preserve Health . 

decay of animal and vegetable matter generates 
numerous substances which impair health and 
create disease; minute microscopic disease germs 
not only float about in the atmosphere, but fre¬ 
quently are carried long distances with the wind. 
Prolific sources of disease are the exhalations and 
effluvia arising from active decomposition in wet 
lands, marshes, swamps, sewers, cess-pools, etc. 

Noxious exhalations when set free, fortunately, 
are diffused through the vast volume of the atmos¬ 
phere. The law of gaseous diffusion, aided by 
winds and storms, secures dispersion and universal 
intermixture, and the proportion of impurities in 
the air we breathe, is thus rendered so small that 
their effect usually is not perceptible; and besides, 
the oxygen of the air destroys and purifies the 
poisonous emanations. The atmosphere, therefore, 
purifies itself by its own action; but the air in 
rooms, dwellings, public buildings, and all confined 
places where there is a limited supply, cannot 
purify itself without assistance from external sources. 
Air to be pure and healthy, requires continual 
circulation. 

Night air is less healthful than that of the day, 
because during the daytime, under the influence 
of the sun, the air near the earth expands and 
rises in an upward current, diluting and carry¬ 
ing away with it the impurities from the earth 
as fast as they are set free; but at night, as 


Pure Air—Its Necessity. 


147 


there is no solar heat to lift and disperse the 
seeds of pestilence, they accumulate and condense 
near the earth. Therefore those exposed to the 
contaminating influence of night air out doors, and 
those who sleep on the first floor of a house, 
three or four feet from the ground, where they 
are directly exposed to terrestrial exhalations, are 
much more liable to disease than those who 
remain indoors at night and sleep in apartments 
on the second or third floor. During the preva¬ 
lence of a certain disease in a prominent city, 
those occupying rooms on the upper floor of the 
house were rarely afflicted, while those on the 
ground floor were the victims. 

The oxygen is soon exhausted from the air of 
occupied rooms by breathing, the burning of fuel, 
combustion for light, etc. ; and unless the supply 
is renewed, there is general depression of the 
vital powers of persons within the apartments, 
which soon terminates in their death. 

The occupants of an unventilated room usually 
do not recognize the poisonous qualities of the 
air they inhale, for their effects are of that stu¬ 
pefying nature that makes people insensible to 
them ; but a person entering from the pure air 
outdoors, quickly perceives the impurities of the 
foul air by their sickening and disgusting odor. 
This is especially noticeable when from the pure 
air we enter an unventilated bedroom in the 


148 How to Sustain Life and Preserve Health. 

morning, where one or two have slept the night 
before. 

Impure air is more apt to create disease than 
improper food. When air is inhaled it passes 
directly into the blood, and its impurities exert 
their injurious effects at once; but as food must 
undergo a long process of preparation, during 
which its noxious ingredients may be rejected 
from the system as unfit material, it is less likely 
to do harm than bad air. 

Impure air not only engenders disease, but its 
immediate effect is to cloud and depress the mind 
so that it has not its usual clearness, shrewdness, 
and energy. Reason loses its keenness of pene¬ 
tration, and the judgment its acuteness of discern¬ 
ment, and we can neither study nor remember so 
well, nor understand so clearly, as when the air 
we breathe is pure. We get impatient and irri¬ 
table, and sometimes instead of seeking relief by 
exercising in the pure and fresh out-door atmos¬ 
phere, foolishly resort to artificial exhilarants and 
stimulants. 

We should endeavor to have the freshest and 
purest air attainable in our rooms; pure air in a 
sick room is one of the cheapest and best medi¬ 
cines ; but when removing foul air from apartments 
and introducing pure air, care must be taken to 
guard against injurious draughts. 

Exercise and Recreation. Exercise and recrea- 


Exercise and Recreation . 


149 


tion are essential to health, and in supplying the 
wants and avoiding the afflictions of the human 
body, they demand special consideration. 

Moderate exercise in the open air assists the 
various secretions of the body and develops the 
physical organism; but to be beneficial to health, 
it should be a pleasure and not a disagreeable, 
hard, mechanical routine. 

Exercise to promote health must be carried on 
in the open air and sunlight. Gymnastics, billiards, 
ten-pins, or any form of indoor exercise, are not, 
as a rule, conducive to health, for they are usually 
associated with impure air. A quiet life in the 
pure open air is more healthful than an active 
life under cover. 

Exercise although essential to health, is detri¬ 
mental to health when very violent, too long 
continued, or exhausting. Moderation, and not 
excess, prolongs life. We should not strive to see 
to how great an extent we can abuse our powers 
without permanent injury, but should endeavor to 
direct them so as to secure our well-being and 
pleasurable existence. Boat-racing, walking matches, 
etc., are not usually conducive to health, as the 
exercise is too excessive; and the accompanying 
excitement and exhaustion may do much harm. 

Mere brute force does not imply health. A man 
may have his muscles enormously developed, he 
may be the. champion oarsman, an expert gymnast, 


150 How to Sustain Life and Preserve Health. 

or the hero of a prize-fight, and yet have a weak, 
nervous system, and be utterly incapable of pro¬ 
tracted study or thought. A man celebrated for 
his great muscular strength and powerful physique, 
usually is not a man of very great intellectual 
attainments; and some of the worst cases of ner¬ 
vous exhaustion are frequently found in men of 
large frames and powerful muscles. Great strength, 
however, is not incompatible with health, but men 
possessing it are apt to abuse their powers. 

The degree of exercise best adapted to supply 
the wants of each individual varies with their age, 
conditions and habits; and of the different kinds 
of exercise, that usually is most healthful which is 
most congenial to the taste; but no exercise should 
be continued beyond slight fatigue ; never to com¬ 
plete exhaustion, or the body will become debili¬ 
tated instead of invigorated. 

Moderate exercise increases the appetite and 
strength, makes the blood flow more freely, pro¬ 
motes respiration and nutrition, and assists the 
preparation and maintenance of animal heat. 
Neglect of out-door exercise by persons of seden¬ 
tary habits induces dyspepsia, impairs nutrition, 
causes muscular weakness, nervous irritability, and 
mental dullness. These evil results accumulate 
gradually but surely. 

The strongest muscles of the body are those 
used the most, and the weakest are those used 


Sleep — Its Necessity. 151 

the least. The size and strength which the mus¬ 
cles gain by exercise can be preserved only by 
its continuance. Muscles permitted to remain in¬ 
active soon lose their fullness and power, and 
become soft and feeble. 

Sleep — Its Necessity. Sleep is a natural state 
of unconsciousness which alternates with a period 
of activity; or in other words, it is a repose of 
the organs of sense, intellectual faculties and vol¬ 
untary motion. The involuntary functions, how¬ 
ever, go on as when awake; the chest moves, 
we breathe, the heart beats, the blood circulates 
and is purified, and the system is nourished. 

Every act that we perform, every movement 
that we make, every thought that passes through 
our minds, every emotion that stirs our souls, 
produces a waste of tissue ; and as the process of 
repair is carried on only during sleep, we must 
have it, or we suffer speedy dissolution. 

As sleep approaches, the activity of the mind is 
diminished and the power of attention lost. The 
senses become blunted to external impressions, our 
ideas get confused, and we feel an intense desire 
for quiet and rest. Our^ muscles become relaxed, 
and we instinctively assume an easy position. 
The first sense lost in sleep is sight, then follows 
the sense of taste, smell, hearing, and finally the 
sense of touch, the most persistent of the senses, 
disappears. Sleep is at first deep, then soft and 


152 How to Sustain Life and Preserve Health. 

gentle, and becomes gradually less sound as the 
time for waking approaches, when usually there 
is an intermediate state between sleeping and 
waking, in which sleep is very light. 

Sleep is nature’s restorer of exhausted power; 
and though we retire wearied, we awake refreshed; 
the muscles then possess greater strength, the 
nerves have attained a higher sensibility, and the 
powers of the mind are more active. A person 
is most easily awakened by the sense of touch; 
next by sounds, then by smell, and finally by 
light. 

The number of hours’ sleep that a person 
requires depends upon the age, health, tempera¬ 
ment, habit, previous fatigue, and climate. There 
are so many circumstances to be taken into con¬ 
sideration, that no precise rule can properly guide 
all; but it may be said that fully developed men 
and women usually need from seven to nine hours’ 
sleep out of every twenty-four. In general, one 
should sleep until he naturally awakes. Infants 
and very old persons require a great deal of 
sleep, and middle life is the period when the 
system requires the least. Men usually require 
more sleep than women. 

Whatever may be the time that an individual 
requires for the recovering of exhausted power by 
sleeping, that time cannot be shortened without 
impairing more or less the strength and activity 


Sleep — Its Necessity. 


153 


of the next day. The body has less energy for 
action, and feels less refreshed when we have 
less sleep than we require. 

We all occasionally devote a night, or part of 
a night, to either travel, labor, business, pleasure, 
attending the sick, etc., and none of us escape 
the penalties that always follow the violation of 
the law of rest. 

The alternations of day and night afford a time 
for activity and a time for rest, and if we wish 
the most perfect sleep and refreshing rest, that 
which most recuperates the system, it must be 
obtained at night when all nature reposes. 

Sleep during the daytime does not fully compen¬ 
sate for the loss of night sleep, and, as a rule, 
it is best for the health to retire at night so as 
to have at least two hours’ sleep before midnight : 
or, in other words, those who habitually retire at 
ten o’clock enjoy better health than those who 
“keep late hours.” The difference in the appear¬ 
ance of a person who habitually retires early, and 
that of one who retires late, is well known. 

The position we occupy during sleep influences 
its strengthening and refreshening power. Sleep 
may occur in the sitting posture, and has occurred 
while standing, walking, and riding horseback,, 
among exhausted soldiers and others; but the 
recumbent position is the best in which to sleep. 
Usually it is best to sleep in whatever position 


154 How to Sustain Life and Preserve Health. 

is most comfortable ; but we should not get in the 
habit of sleeping in one position only ; we should 
alternate and sleep occasionally on either side. 
The right side is better than the left to lie upon 
for any length of time, as usually it does not 
interfere with the action of any of the vital 
organs. 

A young person should not sleep in the same 
bed with an old one, as the younger in such a 
case will lose vitality; and, as a general rule, it 
is more healthful for each person to occupy a bed 
alone. 

Sleep is most refreshing when taken in a large, 
well-ventilated room. The bed should be neither 
too hard nor too soft; a very hard bed affords 
but few points of support for the body, and con¬ 
sequently less comfort is enjoyed than in a mod¬ 
erately soft one where the weight of the body 
presses on a larger surface ; but when the bed is 
an exceedingly soft, downy one, it debilitates rather 
than strengthens the sleeper, as it allows the 
body to sink within it, and keeps up too great a 
heat. It is considered best for the health to have 
the head of the bed toward the north, as it puts 
the sleeper in harmony with the electrical cur- 
rents caused by the motion of the earth on its 
axis. 

Frequently people are unable to obtain the 
amount of sleep that they require ; they may have 


Sleep — Its Necessity. 


155 


the time for sleep, but be troubled with persist¬ 
ent wakefulness. The absence of sleep, sleepless¬ 
ness, or insomnia, as it is termed, is an indica¬ 
tion of suffering in some organ, although the 
patient may experience no real pain. All exciting 
passions have a tendency to prevent sleep; and 
mental anxiety with doubt or uncertainty as to 
the result of some important action of life, will 
cause morbid wakefulness which, when persistent, 
is a prominent cause of lunacy. Sleeplessness not 
only forms one of the premonitory symptoms of 
insanity, but it is usually present in mania greatly 
aggravating the disease. 

The length of time that a person may exist 
without sleep varies with different persons. In the 
restoration of the exhausted energies of both mind 
and body sleep is as necessary as food and drink ; 
and the suffering caused by enforced wakefulness 
is equal to that experienced when deprived of 
water. 

A Chinaman who murdered his wife in 1859, 
was sentenced to die by being deprived of sleep. 
He was placed under the care of a guard which 
was relieved every alternate hour, and was thus 
prevented from falling asleep night or day; and 
after living nineteen days without any repose he 
died. His sufferings were so intense that on the 
eighth day he implored the authorities to grant him 
the blessing of being strangulated, guillotined, 


156 How to Sustain Life and Preserve Health. 

burned to death, drowned, garroted, shot, quar¬ 
tered, blown up with gunpowder, or put to death 
in any conceivable way which their humanity or 
ferocity could suggest. 

Damiens, who was tortured in Paris, in 1757, 
for attempting to assassinate Louis XV., is said 
to have remarked just before he died, “that the 
deprivation of sleep had been the greatest of 
all his torments.” 

F'ive young men recently attempted, for a 
wager, to keep awake seven days. They pre¬ 
vented sleep for a time by drinking freely of 
strong coffee, and keeping up a constant round 
of active exercises and exciting amusements; but 
at the expiration of five days two of them were 
overcome by sleep, a third was compelled to 
retire by sickness, a fourth soon after fell asleep 
while riding horseback, and tumbled from the 
saddle, and the fifth held out to the seventh 
day, and won the wager, but lost twenty-five 
pounds of flesh. 

When afflicted with unnatural wakefulness, the 
means used to procure repose must vary with the 
cause of the wakefulness and excitability. Sufferers 
from sleeplessness usually have a strong tendency 
of blood to the brain, with cold extremities ; and 
the pressure of blood on the brain keeps it in 
a stimulated or wakeful state. During sleep the 
arterial circulation of the brain is at its minimum, 


Sleep — Its Necessity. 


157 


and when awake the use of remedies which 
diminish the quantity of blood in the brain 
are promotive of sleep. Sleep procured by medi¬ 
cine is rarely as beneficial as that secured 
naturally, for medicines frequently disturb the 
nervous system, and thus counteract to a certain 
extent the good results of sleep. People should 
not, therefore, take drugs to procure sleep without 
the advice of a physician. 

The following suggestions will be found ser¬ 
viceable to persons afflicted with persistent wake¬ 
fulness when they require sleep. Before seeking 
repose, sufficient muscular exercise should be taken 
to produce weariness, but not exhaustion; the 
mind should be as free as possible from care 
and anxiety; exciting reading, excessive brain 
work, and tea and coffee should be avoided in 
the latter part of the day; the food consumed 
should be digestible, and such as will not favor 
the production of flatulence or acidity; and the 
patient should retire to rest at an early, regular 
hour, in a clean, comfortable bed, in a large, 
quiet, well-ventilated room. 

The sufferer from unnatural wakefulness may 
often be very sleepy before retiring to rest, but 
become wide awake after going to bed. He 
should then arise and try to withdraw the 
excessive amount of blood from the brain, by 
rubbing the body and extremities with a crash 


158 How to Sustain Life and Preserve Health. 

towel, or flesh-brush, or in warm weather take a 
good bath, and sleep frequently will follow in a few 
minutes. A short, rapid walk in the open air, 
or going up and down-stairs a few times just 
before retiring, will aid in equalizing circulation 
and promoting sleep. A pillow containing fresh 
hops will often produce sleep when many other 
remedies fail. 

Although, as a rule, it is not a good plan to 
sleep with high pillows, some persons troubled 
with sleeplessness find it best to recline with 
the head and shoulders slightly raised; and thus, 
by gravitation, the flow of blood to the. head is 
retarded, and sleep promoted. For the same 
reason they frequently get into the “land of nod” 
while comfortably seated in an easy chair. 

Recourse may be had to medicines if attention 
to these simple rules fail to produce the desired 
effect. When any physical cause for the wake¬ 
fulness exists, it must of necessity be removed. 

Different kinds of Food , and their Mode of Prepa¬ 
ration. Food of all kinds has been divided into 
two classes: those substances which do contain 
nitrogen, and those which do not. The first class 
is called nitrogenous or albuminous, and is devoted 
to the production of blood, flesh, etc. The basis 
of animal tissue is nitrogen, and the muscles 
are identical in composition with the nitrogenous 
principles of food. 


Different kinds of Food. 


159 


The second class, called non-nitrogenous sub¬ 
stances, are fats, oils etc., and are largely used in 
cold countries to sustain the vital heat. They 
readily attract the oxygen inhaled, and seem devoted 
to simple combustion in the system with only the 
evolution of heat. 

Food intended for eating should be carefully 
and properly prepared. It should be attractive, 
of the desired flavor, and nutritious; and the 
cooking should be managed so as to accomplish 
these ends. All of the nutritious juices of meat 
are soluble in cold water, therefore in the prepara¬ 
tion of meat for food, by boiling, the water should 
be boiling hot when the meat is placed in it, so 
as to coagulate the albumen on the surface, thus 
forming a crust, which prevents the escape of the 
nutritious juices; but in making soup, the meat 
should be put in cold water and gradually raised 
to the boiling point. 

In roasting and broiling meat, it should first be 
applied to a strong heat, so as to coagulate the 
albumen, and form a crust to retain the juices, as 
in boiling. The effect of heat applied to meat in 
boiling, roasting and broiling, is to coagulate the 
albumen in the muscular tissue, and soften and 
gelatinize the cellular tissue between the muscular 
fibres; the fibres are then more easily separated 
from each other, and the whole mass is thus ren¬ 
dered more tender and digestible. The heat 


160 How to Sustain Life and Preserve Health , 

develops in the albuminous ingredients of the meat 
a peculiar and attractive flavor, which excites in a 
healthy manner the digestive secretions. Fried 
meat is not as wholesome as boiled, roasted, or 
broiled, as frying is performed with heated fat or 
oil, which is decomposed during the operation. 

Salting, pickling, and smoking meat, hardens its 
texture, and renders it less palatable, less digestible, 
and less nutritious. Salting renders meat less nutri¬ 
tious, because a large quantity of albumen, 
soluble phosphates, lactic acid, potash, creatine and 
creatinine, are abstracted in the brine. Of all the 
different varieties of meat, beef is the most valuable, 
mutton and venison next, then the flesh of fowls, 
and lastly fish. 

Pork is the principal meat of some families; 
but whether salt or fresh, it is slow to digest, 
and should be eaten only by those who have 
strong constitutions and work hard in the open air; 
and then should be eaten only when no other food 
can be obtained. It is nutritious, but it frequently 
contains a parasite called trichina, which may be 
transferred to the human system and cause disease, 
especially when the pork is not cooked thoroughly. 
The hog is the filthiest of animals, and those who 
eat its flesh do so at the risk of disease. 

Vegetables are healthful and indispensable as 
food, for man requires a mixed diet : flesh, fish, 
vegetables and fruit. Vegetables and fruit are 


Different kinds of Food. 161 

rich in valuable saline substances which act as 
antiscorbutics (preventives of and remedies for 
scurvy), and are therefore essential to the system. 
They vary in their digestive and nutritive quali¬ 
ties according to the proportion of their constit¬ 
uents, and the way they are prepared for eating. 
Vegetables in their raw state are usually so hard 
as to be entirely indigestible, but cooking softens 
and disintegrates them and makes them more 
palatable. Most esculent vegetables abound in 
indigestible ligneous tissues which excite intestinal 
movement, and thus incline to produce aperient 
effect. Such vegetables as potatoes, beans, peas, 
turnips, etc., contain principally starch mingled 
with various proportions of albuminous matter, 
sugar, water, and mineral substances. 

Potatoes contain a large proportion of starch, 
and when mealy are easy of digestion either 
boiled or baked. Beets, parsnips, carrots, etc., 
which contain a large proportion of sugar, are 
best cooked by steam, as boiling water dissolves 
a large quantity of their nutritious ingredients ; 
most vegetables, however, are best boiled. Toma¬ 
toes are healthful, and are relished by'most persons 
either raw or cooked, cold or hot. Their effect 
on the system is similar to that of fruit. Onions 
are not popular as food in fashionable society, as 
they have a peculiar volatile oil which is not 
assimilated or destroyed in the body, but escapes 


162 How to Sustain Life and Preserve Health. 

through the lungs, contaminating the breath ; still 
they possess many virtues. They are of especial 
benefit to nervous persons troubled with sleepless 
nights, and to persons afflicted with coughs and 
colds. 

Fruits, although used for food, are prized not 
so much for their nourishing and strengthening 
power, as for their delicious and refreshing taste, 
which is caused by a combination of sweets and 
sours, sugars and acids. They are considered more 
as a luxury than as articles of food, and afford 
less nourishment than any other class of aliment. 
In green fruit the sour taste predominates, and 
although the quantity of acid increases as the 
fruit ripens, yet the sugar increases so much 
faster, that there is a gradual sweetening as the 
fruit matures and the acids become enveloped in 
sugar. In stewed fruit prepared for food, the 
sugar and vegetable jelly cover or mask the acids 
and salts, and thus check their irritating action 
upon the inner coating of the digestive passage. 
Fruits act on the system in the capacity of 
refrigerants, tonics, and antiseptics, and prolonged 
abstinence from fruits and succulent vegetables 
brings on a disease called scurvy, which has been 
very destructive to voyagers at sea, explorers of 
barren regions, and large armies. 

Condiments—Their Effect on the System. Condi¬ 
ments are used for flavoring food and rendering 


Condiments—Their Effect on the System. 163 

it palatable ; but they serve other purposes besides 
ministering to the taste. Sugar, oil, acids and 
common salt have been described as aliments, but 
they are also employed as condiments. There are 
various kinds of condiments, but most of them, 
as pepper, mustard, horse-radish, and the various 
spices, possess stimulant properties. 

Common salt is universally used as a condi¬ 
ment ; it is a constant ingredient of the blood, 
and man could not live without it. It is nat¬ 
urally present in the food we consume, but not 
usually in sufficient quantity for the demands of 
the system ; therefore we add it to most of the 
substances we eat. The desire for salt is in¬ 
stinctive, and indicates the natural craving of the 
system for something which is essential to its 
organization. Common salt by decomposition in 
the presence of water, yields an acid and an 
alkali — hydrochloric acid and soda; this separa¬ 
tion is affected in the system, and is the chief 
source of the hydrochloric acid of stomach diges¬ 
tion. After salt performs its office in the system, 
it escapes by the kidneys, intestines, mucous, 
perspiration and tears. Abstinence from salt pro¬ 
duces disease and death; and as the excessive 
use of salt produces the same result, we should 
use it only in such quantities as are proportioned 
to our actual wants. 

Black pepper is more extensively used than any 


io4 How to Sustain Life and Preserve Health. 

other condiment excepting salt. When .used in 
proper quantities it excites warmth in the throat 
and stomach, quickens the appetite and digestion, 
and tends to prevent flatulence from vegetable 
food. Black pepper, cayenne pepper, mustard and 
the various spices, owe their stimulant quality to 
the presence of a volatile oil. 

The volatile oils of mustard, horse-radish, parsley, 
caraway, anise, fennel, water-cress, thyme, etc., 
stimulate the system, but do not incorporate them¬ 
selves. Fluid mixtures of condiments are called 
sauces; but in whatever form condiments are used, 
their daily use injures the tone of the stomach 
after a time, and impairs the digestive function. 
The only exceptions are salt and vinegar. 

Different Kinds of Drinks , and their Mode of Prep¬ 
aration. Drinks are liquids introduced into the ali¬ 
mentary canal, usually for the purpose of repairing 
the loss of the fluid parts of the body, which loss 
is indicated by thirst ; but drinks are also used for 
the purpose of nutrition, as when beef tea, etc., are 
consumed, and for stimulation when alcoholic 
liquors are imbibed. 

Drinks may be divided into the following seven 
classes, the first of which enters into the formation 
of each of the others : ist. Water, a clear, color¬ 
less, tasteless, and inodorous liquid. 2d. Mucilagi¬ 
nous, farinaceous, or saccharine drinks, as flax-seed 
tea, etc., which are a little more nutritious than 


Different kinds of Drinks. 165 

water. 3d. Aromatic or astringent drinks, such as 
tea, coffee, chocolate, cocoa, etc. The last two 
contain oil and starch, and all of them contain 
principles which slightly exhilarate the nervous sys¬ 
tem. 4th. Acidulous drinks, such as lemonade, 
currant juice water, raspberry vinegar, etc. They 
allay thirst and form cooling and antiscorbutic 
drinks. 5 th. Drinks containing gelatine and ozma- 
zome, including broths, beef tea, soup, etc. These 
when properly made, ought to contain all the solv¬ 
able constituents of the substances from which they 
are prepared. 6th. Emulsive or milky drinks, such 
as animal milk, cocoanut milk, almond milk, etc. 
Milk of animals contains the essential ingredients 
of food, and the others are slightly nutritive. 7th. 
Alcoholic and other intoxicating drinks, including 
beer, wines and spirits. When drinks of either of 
these seven classes are used for medical purposes, 
they are called medicinal drinks. 

Water is the natural beverage of mankind ; and 
pure water like pure air is essential to good health. 
It consists of eight parts by weight of oxygen to 
one of hydrogen, or one part by measure of oxy¬ 
gen to two of hydrogen. 

Water, as found in nature, is never perfectly 
pure. It comes in contact with a great number 
of substances which it dissolves, so that it is 
always contaminated with foreign matter; and poi¬ 
nted water, like impure air, is one of the most 


166 How to Sustain Life and Preserve Health. 

common sources of disease. The foreign substances 
or impurities which the water acquires communi¬ 
cate their properties to the liquid, and thus there 
are many varieties of natural water; as for instance, 
rain water, spring water, well water, river water, 
and sea water. 

Rain water is the least contaminated of natu¬ 
ral water; but it almost always contains carbonic 
acid, carbonate and nitrate of ammonia, and other 
constituents depending on the locality in which it 
falls. It absorbs and washes out of the atmos¬ 
phere whatever impurities it may contain. The 
purest of rain water, the purest water that nature 
provides, is that which falls in the open country, 
away from contaminating influences, at the close 
of a protracted rain-storm. It differs from dis¬ 
tilled water only in being charged with the pure 
and natural gases of the air. Perfectly pure water 
can only be obtained by distillation. It tastes flat 
and mawkish, because it does not contain the solid 
matter that we are accustomed to drink. 

Water is usually divided into hard and soft. 
Hard water is that which contains compounds of 
lime and magnesia in solution. Soft water is that 
which is free from mineral matter. It is rain 
and snow water, and that obtained from some 
springs, and is usually the most healthful, as it 
passes into organized tissues more readily than 
hard water. Its solvent and extractive action is 


Different Kinds of Drinks. 167 

4 also greater, and therefore it is a better vehicle 
for conveying nutritious substances into the living 
system; yet a water moderately hard is not 
usually detrimental to health. 

. The chief source of danger in drinking impure 
water is from what is called organic impurities 
such as arise from decayed leaves, insects, decom¬ 
posing bodies of dead animals, the wash of ground 
contaminated with effete and decaying matters, 
and the drainage of cesspools, barnyards, sinks, 
pens, and similar places. Wells should therefore 
be widely separated from places where the water 
is liable to become contaminated by infiltration 
from the surrounding surface ; and cisterns should 
be properly constructed, kept clean, and then if 
the water is filtered and a little ice added, nothing 
better can be obtained in the way of an aqueous 
luxury. 

Tea, coffee, chocolate, and cocoa, are familiar 
to everybody, and either one or the other of these 
drinks are used daily by most persons, many of 
whom have become so habituated to the use of 
their favorite drink, that they “could not enjoy a 
meal without it.” They are slaves to their bev¬ 
erage the same as the tobacco-user is a slave to 
tobacco, or the whiskey-drinker a slave to whiskey. 

Tea acts on the human body as a stimulant, 
sedative and astringent. The ingredients of tea 
to which it owes its action, are theine, tannic 


168 How to Sustain Life and Preserve Health. 

acid, and a volatile oil. If eight or ten grains of 
theine, the quantity contained in an ounce of good 
tea, are swallowed, it causes the heart to beat 
stronger, the pulse to become more frequent, the 
imagination to become excited, the thoughts to 
wander ; visions begin to be seen ; the body trem¬ 
bles ; and a peculiar state of intoxication super¬ 
venes : these symptoms are followed by and pass 
off in deep sleep. Tea-drinkers of course do not 
take eight or ten grains of theine at one dose; 
they merely take one or two cups of a hot infu¬ 
sion of tea, which has a far different effect. 

Tea is the favorite drink of women. It dimin¬ 
ishes the need of food while it quickens the activity 
of the nervous system. Excess in the use of tea 
causes indigestion, headache, lowness of spirits, and 
faintness ; but used moderately it enlivens the mind, 
soothes the body, and lessens the waste of the 
system ; therefore it may appropriately be designa¬ 
ted as “the cup that cheers, but does not inebriate.” 

Coffee owes its properties chiefly to the presence 
of an alkaloid called caffeine (which is identical in 
properties with theine of tea), and volatile oil. Both 
of the ingredients contribute to heighten vascular¬ 
ity and nervous activity, and at the same time 
retard the decomposition of the tissues 

The effect of coffee is to arouse, exhilarate, and 
keep the drinker awake, and, to a certain extent, 
allay hunger. It counteracts the stupor occasioned 


Different Kinds of Drinks. 169 

by fatigue, by disease, and by opium; it gives 
increased strength and vigor to the weary, and 
imparts a feeling of comfort and repose ; but, like 
tea, it is injurious when used to excess, and persons 
of sedentary habits should not make a daily use of 
strong coffee. 

Chocolate and cocoa are manufactured from roasted 
cacao beans, which grow in the West Indies, Mexico, 
and South America. The chocolate and cacao are 
made into a paste by long trituration in a heated 
mortar, with sugar, vanilla and cinnamon, and then 
poured into a mold and left to harden and dry. 

Chocolate and cocoa are composed of albumen, fat, 
and a nitrogenized principle partaking of the active 
alkaloid of both tea and coffee — theine and caf¬ 
feine— and with the presence of sugar they are nutri¬ 
tious as well as grateful beverages. They are more 
healthful when pure than tea or coffee; but at 
the present time, when almost everything is adul¬ 
terated, it is difficult to obtain a pure and reliable 
article. The mode of preparing tea, coffee, choco¬ 
late, and cocoa is familiar to every one, and requires 
no special mention. 

Medicinal drinks are so called because they form 
an important part in medical practice as accessories 
to medicine, and in some cases, as absolute reme¬ 
dies. They are prepared by boiling and by infu¬ 
sion ; and are used to quench thirst, allay heat, 
abate fever, and supply the system with nutriment. 


lyo How to Sustain Life and Preserve Health. 

Those prepared by boiling are called decoctions, 
and in their preparation, the drug or substance 
used should be first placed in cold water, and 
should be gradually heated, as this insures the 
complete extraction of all the soluble principles ; 
the albuminous matter being subsequently coagu¬ 
lated as the heat is near the boiling point. The 
time of actual boiling should not exceed ten or 
fifteen minutes. If the drug or substance be at 
once immersed in boiling water, the albumen con¬ 
tained in the cells would be coagulated, and thus 
interfere with the extraction of the other princi¬ 
ples. 

Infusions are watery solutions of the soluble prin¬ 
ciples of substances or drugs obtained by macera¬ 
tion or digestion in hot or cold water, and differ 
from decoctions only in the lower degree of heat 
employed in their preparation. Those substances 
which contain volatile and other principles which 
would be dissipated or injured by boiling, should 
be prepared in this way. 

The following are some of the most valuable form¬ 
ulas of both decoctions and infusions, and probably 
every family at some time or other, will have occa¬ 
sion to use some of them. 

Beef Tea. Cut fine one pound of fresh lean beef; 
put it with one quart of cold water in a suitable 
vessel, and let it stand a half-hour, then place it 
over a slow fire where it can be gradually heated 


Mutton, Chicken , and Veal Broths. lyi 

for an hour, at the expiration of which time it 
should reach the boiling point and boil ten or fifteen 
minutes, when it may be strained, seasoned, and 
is then ready for use. 

Beef tea as thus prepared is highly nutritious, with 
an agreeable rich meaty flavor, and is especially 
valuable for persons who are weak, emaciated, and 
with feeble vital powers from impoverished blood ; 
and also for persons when the digestive powers 
will not admit of solid food. 

Mutton , Chicken , and Veal Broths. Either of these 
may be made the same as beef tea, but should be 
boiled much longer. Use the fleshy part without 
fat. A little rice may be added, and they may be 
flavored with celery, parsley, or an onion if desired. 
Strain, season, and they are ready for use. 

Rice Water. Wash carefully two tablespoonfuls 
of rice; place it in five pints of cold water, and 
gently heat it for three hours, and then boil slowly 
for one hour, and strain. It may be sweetened 
and flavored with orange peel. Rice water when 
used as a drink in diarrhoea, may have a little 
brandy of the best quality added to it. 

Barley Water. Take two ounces of pearl-barley, 
carefully washed, and boil it twenty minutes in 
one quart of water, in a covered vessel. Strain, 
sweeten, and add the juice of one lemon, and it 
is then ready for use. 

Barley water, the most ancient of fever-drinks, 


172 How to Sustain Life and Preserve Health. 

is readily digested, is nutritious, unirritating, and, 
in many cases, is superior to drinks made from 
any other cereal. The decoction may be rendered 
more or less nutritious by longer or shorter boil¬ 
ing, according to the state of the patient. 

Oatmeal, sago, or flour, may be used for the same 
purpose, except that powdered substances are to 
be first mixed into a paste with cold water. 

Buchu Tea. Pour one pint of boiling water upon 
one ounce of fresh buchu leaves, and let it stand 
in a covered vessel two hours, and then strain. 

Buchu tea is useful in disorders of the urinary 
organs. It contains all the virtues of buchu, and 
is preferable to more concentrated forms of the 
medicine. Frequently an infusion is made with- 
equal proportions of buchu and bearberry leaves, 
and in most cases gives better results than the 
buchu alone. Dose, from one half to a wineglassful. 

Cayenne Pepper Tea . “Take of capsicum in coarse 
powder, half a troy ounce, boiling water a pint. 
Macerate for two hours in a covered vessel, and 
strain. U. S. 

“ Medical uses. — Infusion of capsicum is used 
almost exclusively as a gargle in the treatment of 
pseudo-membranous and gangrenous affections of the 
throat , including those conditions in scarlet fever 
and the forming stage of simple inflammation of 
the same part. No other local treatment is more 
efficient, and none, perhaps, as much so. When 


Clove Tea. —Boneset Tea. 


173 


patients are unable to use the infusion as a gargle, 
it may be applied with a mop. The following prep¬ 
aration has had a great reputation in malignant 
sore throat : Take two tablespoonfuls of capsicum, 
and the same quantity of fine salt ; beat them into a 
paste with a little water, and add half a pint of 
boiling water. Strain off the liquor when cold, 

and add to it half a pint of very sharp vinegar. 
Of this the dose for an adult is a tablespoonful 
every half hour. Except when the throat is 
covered with false membrane and with sloughs, 
the acrimony of this preparation is not easily 

borne .”—National Dispensary. 

Clove Tea. Take one teaspoonful of bruised 
cloves, and one pint of boiling water, mix them 
in a covered vessel, and let it stand for two 

hours, then strain. 

Infusion of cloves may be given in table¬ 
spoonful doses to allay flatulent colic, and nausea 
from exhaustion. 

Boneset Tea. Add one ounce of boneset to 

one pint of boiling water, and after the mixture 
has stood two hours in a covered vessel, 
strain. 

Boneset tea has been used alone, and in con¬ 
nection with quinine for intermittent fever, and 
also to produce perspiration. For the latter 
purpose it should be given hot. The dose is 
from one half to a wineglassful. Frequently an 


174 How to Sustain Life and Preserve Health. 

infusion is made with equal proportions of bone- 
set and hops. 

Juniper Berry Tea . Mix one ounce of bruised 
juniper berries with one pint of boiling water, 
let it stand for an hour in a covered vessel, 
then strain, and a little pure gin may be added 
if desired. 

This preparation has a stimulant and diuretic 
effect, and is used in dropsies and in chronic 
affections of the urinary passages. Its effect on 
the kidneys may be increased by the addition of 
parsley, horse-radish, or buchu leaves. The dose 
of the infusion is a wineglassful every three 
hours. 

Flaxseed Tea. Take one ounce of flaxseed, not 
bruised, and two drachms of licorice <*root cut 
fine. Add them to one pint of boilin'g water, 
and strain after the mixture has stood two hours 
in a covered vessel. The juice of a lemon and 
a little honey may be added if desired. 

This preparation may be used freely for coughs 
and colds. * 

Tar Water. Mix one pint of tar with two 
quarts of water, and shake the mixture frequently 
during twenty-four hours, and then strain. 

Tar water may be used in doses of from one 
half to a wineglassful to relieve chronic bron¬ 
chitis and mucous disorders of the urinary 
organs. 


Sage Tea.—Facts and Fallacies. 175 

Sage Tea. Mix one ounce of fresh sage leaves 
with one pint of boiling water, and let the 
mixture stand one half-hour in a covered vessel, 
and then strain. 

This is an ancient medicine; it is stimulant, 
tonic, and astringent. Taken cold in wineglassful 
doses, it moderates excessive sweats. Fifteen 
drops of aromatic sulphuric acid added to a 
wineglassful of the tea, and taken every three or 
four hours, usually proves an effectual remedy 
for the sweats of consumptives. When sage tea 
is used as a mouth wash, a little borax, alum, 
or chlorate of potash, may be added to it. 

Ginger, pennyroyal, wormwood, camomile flowers, 
dandelion root, fennel seed, spearmint, peppermint, 
rue, etc., are among the other articles used for 
drinks made by infusion. They may be prepared 
the same as other infusions, but use a little care 
and not make them too strong by adding too 
much. When the object of giving drinks of this 
nature is to produce perspiration, they should be 
given hot; but if perspiration is not desired, they 
should be given cold. 

Facts and Fallacies concerning Eating and Drinking. 
There is a great diversity of opinion among the 
mass of people as to what constitutes a proper 
diet. This *is due to the fact that as people are 
differently constituted, one may eat what another 
cannot ; and that the relation between certain 


176 How to Sustain Life and Preserve Health. 

kinds of food and drink, and the wants of the 
body, require some study and care to be properly 
understood. Every one is willing to admit, how¬ 
ever, that the journey of life is beset with 
temptations to eat and drink certain things 
which experience has proved to be unsuited 
for us. 

If our food is not carefully selected, properly 
cooked, or thoroughly masticated, we are pain¬ 
fully reminded of the fact by the symptoms of 
indigestion, if in no other way; but when our 
food is properly selected, prepared, and eaten, 
the process of digestion is not made manifest by 
a conscious sensation. 

Hunger is a sensation which indicates that 
the system requires more nourishment ; it differs 
from taste, which merely indicates the pleasant¬ 
ness of the food while in the mouth. The 
appetite in preference to taste, therefore, should be 
our guide in supplying the wants of our bodies. 
Those who eat and habitually overload their 
stomachs merely because food tastes good, engen¬ 
der disease and shorten their lives ; for as a rule, 
there is no digestion without appetite. 

The appetite is influenced by many circum¬ 
stances. In certain diseased conditions, extreme 
anxiety, fatigue, anger, or unusual excitement, the 
appetite fails. It also may be suspended by 
sudden mental emotion, as when a person very 


Facts and Fallacies. 


177 


hungry sits down to eat, but just before taking 
the first mouthful, receives news of the death of 
a near relative or intimate friend; the appetite 
is gone at once, overcome by grief, and may not 
return for several days. 

Although the appetite usually fails in disease, 
there is certain diseased conditions in which 
there is a voracious desire for food; but gen¬ 
erally associated, however, with feeble power 
of digestion. This is the case in some states 
of dyspepsia, and during convalescence from 
fevers, when the appetite returns before the 
power of digestion. Idiots usually have an extra¬ 
ordinary appetite, which they indulge to excess 
when an opportunity offers. If food is eaten 
according to the appetite in these cases, it gives 
oppression and weakness instead of strength and 
vigor. 

Aside from disease, an individual may have an 
appetite for much more food than his body 
requires. A healthy man may indulge in the 
perverse habit of excessive eating because he 
has a bountiful supply of food, and because it 
is pleasant to his taste; he thus distends his 
stomach greatly beyond its natural capacity, and 
by repeated indulgences or indiscretions, the 
enlarged and unnatural state of the stomach 
becomes permanent. He has cultivated that con¬ 
dition in which his stomach will not act upon 


178 Hozv to Sustain Life and Preserve Health . 

a small quantity of food; it is accustomed to 
great distension, and to relieve the hollow feel¬ 
ing, the appetite has acquired a corresponding 
increase of voracity. Those with this habit are 
no better nourished than those who eat less, as 
only sufficient food is assimilated for the wants 
of the body, and the excess passes through the 
system as waste material. Perhaps a remedy for 
persons afflicted in this way would be to spend 
six months at the average city boarding-house, 
for landladies frequently use their best endeavors 
to reduce the capacity of their boarders’ stomachs. 
Although there are gluttons in all classes of 
society, they are exceptions among intelligent 
people, and in civilized lands. 

People as a rule, eat too little rather than 
too much; especially in our large cities, where 
thousands of unfortunate children die of actual 
starvation because their parents are too ignorant 
or too poor to give them what is necessary to 
sustain life. Men, and women too, are sometimes 
forced by extreme poverty into a systematic 
habit of unintentional starvation; or they may 
have money, but be too penurious and ignorant 
to supply themselves with sufficient nutriment 
for the demands of their bodies, and gradually 
day after day their vital powers decline, strength 
and bodily weight slowly become less, and they 
become moody, ill-tempered, and repulsive. Then 


Facts and Fallacies. 


179 


comes disease, perhaps slight at first, but the 
body being in so poor a condition to resist it, a 
long, lingering sickness and death frequently 
result. The process may be slow, but it is 
sure. 

The quantity of food necessary to preserve 
health and sustain life depends upon an individ¬ 
ual's age, occupation, habits, state of health, and 
the climate or temperature in which he exists. 
Therefore no definite or satisfactory rule can be 
prescribed for all. Labor, either mental or physi¬ 
cal, in fact, every thought and every motion of 
the body causes waste of the tissues, and the 
quantity of nutriment a man requires varies 
chiefly with the energy and quantity of action 
which the system is called upon to sustain. 
Persons who labor hard, and those who have 
active habits or exercise a great deal, require 
more food than people of sedentary habits or 
idlers; but the same man does not require the 
same quantity of food when engaged in light 
employment, as when laboring hard. Nutritive 
wants change with habits. 

Frequently men accustomed to active exercise 
suddenly discontinue their labors and lead a 
sedentary life, but their appetite, unfortunately, is 
not so quickly reduced, and they eat the same 
quantity of food as before, which, being in 
excess of their nutritive wants and digestive 


i8o How to Sustain Life and Preserve Health. 

powers, the stomach is overburdened, and dyspepsia 
with its usual train of evils follow. Light employ¬ 
ments are not necessarily injurious to digestion, as 
has been supposed; but as they require less 
activity, there is less waste, less use for food, 
and as a consequence, less digestive power; and 
food, as a matter of course, becomes oppressive 
and injurious when these conditions are dis¬ 
regarded. 

In a state of health the digestive powers of 
the stomach correspond with the nutritive wants 
of the body, and when a man eats sufficiently 
to supply these wants, and no more, he feels 
satisfied and refreshed ; but if on the contrary 
he consumes more than enough, he experiences 
a full, oppressive, uncomfortable feeling, which 
is a hindrance to both business and pleasure. 

If a man would make a distinction between 
appetite and mere taste, and then leave taste out 
of consideration and follow only the dictates of 
his natural appetite, it would be a better guide 
to him in selecting food and measuring its quan¬ 
tity, notwithstanding its liability to perversion, 
than all the hygienic rules that have ever been 
formulated. 

We should eat to obtain nourishment and 
strength, and not for the mere pleasure of 
swallowing delicacies that tempt the palate. 
There is a tendency among ladies when enter- 


Facts and Fallacies. 181 

taining guests, to offer and urge them to eat a 
quantity of rich, delicious food, highly pleasing 
to the taste, but not adapted to the wants of 
the body, and thus they impose a burden on 
their friends’ stomachs in their well-intentioned 
efforts to please them. 

The advice of Socrates, a Greek philosopher, 
born b. c. 469, although over two thousand years 
old, may be followed with advantage on such 
occasions. It was, “ Beware of such food as per¬ 
suades a man, though he be not hungry, to eat ; 
and those liquors that will prevail with a man 
to drink them when he is not thirsty.” 

How often should we eat, and when is the 
best time ? This is a question often asked, and 
variously answered. Diogenes, an eccentric Greek 
philosopher, born b. c. 413, said that the proper 
time to eat was, “for a rich man when he could 
get an appetite, and for a poor man when he 
could get food.” This advice, however, does not 
tell the number and time of meals best adapted 
to the wants of the body. People, as a rule, 
enjoy better health, and find the wants of their 
bodies best supplied, by following the established 
custom of eating three regular meals daily — 
breakfast, dinner, and supper; and as the appe¬ 
tite is easily trained to regular habits, these 
meals should be served at regular hours; but 


182 How to Sustain Life and Preserve Health. 

children, and active growing young people, require 
food oftener than fully developed adults. Those 
recovering from typhoid fever and other diseases 
in which the body is wasted, also require nour¬ 
ishment at shorter intervals than the healthy, 
that their bodily loss may be restored. It is 
better for children, and those recovering from 
sickness, to eat often, in moderate quantities, than 
to wait several hours and then eat to excess. 

Healthy adults feel the desire for food at their 
usual hour of eating; then their appetite has 
returned, their stomach craves food, and the 
gastric juice is ready to flow and digest it; 
but if they do not eat, the demands of their 
appetite may become urgent, and after a time 
cease, until the next usual hour of eating, when 
it returns with increased force. When regular 
hours of eating are observed, the stomach regu¬ 
lates its wants in accordance with the periods of 
supply; but when a regular meal is omitted, the 
stomach is apt to become burdened with an 
excessive quantity at the next meal, and the 
digestive powers are thus overtaxed. 

Breakfast, the first meal of the day, should be 
eaten within an hour after rising, for most 
persons experience an uneasy sensation of languor 
or faintness in the morning until they have eaten 
something. One would naturally suppose from 


Facts and Fallacies. 183 

the long interval between the morning meal, and 
the meal the previous evening, that they would 
have a greater appetite for food in the morning 
than at any other time during the day; but such 
is not the case, for during the hours of sleep 
there is little or no action of the body, and 
therefore but little waste. 

Dinner, the chief meal of the day, is eaten by 
different persons at different hours. The estab¬ 
lished hour with most people is between twelve 
and one o’clock, but with business men in our 
large cities this is often their busiest time, and 
therefore they take a lunch in the middle of the 
day, and eat their dinner late in the afternoon or 
early in the evening. This, under the circumstances 
is the best course for them to pursue, but the 
middle of the day is the best time for people to 
eat dinner who can have a quiet leisure hour 
regularly ever)' day at that time. 

Supper, the evening meal, should be eaten about 
three hours before sleeping. Late, hearty suppers 
are injurious to health, because active digestion 
and sleep mutually disturb each other; still, the 
opposite extreme of sitting up late and going to 
bed tired, hungry, and with a faint and empty 
feeling in the stomach, is also injurious to health. 
In such cases a little light, easily digested food 
usually prevents unpleasant effects. 

“ The general custom of three meals a day — 


184 How to Sustain Life and Preserve Health . 

a good breakfast soon after rising in the morning, 
a fuller and more nutritious meal near the middle 
of the active part of the day, and a lighter meal 
a few hours before sleeping — meets the wants of 
the body, and corresponds with the powers of 
digestion. But when we add to these lunches 
during the day, or take a supper of feasting for 
hospitality or self-indulgence at night, we over¬ 
step the demands for nourishment, and overtask 
the powers of digestion, and prevent the full, 
refreshing effects of sleep at night.”— Dr. Jarvis' 
Physiology and Laws of Health. 

The importance of taking our meals at regular 
hours, and thus avoiding an intensely hungry, 
faint feeling, cannot be over-estimated in supplying 
the wants of the body. Dr. Jarvis speaks as 
follows on this subject: # 

“ The animal system sustains all active labor 
and exposure best when it is well nourished. 
When the nutriment fails, it becomes sooner 
fatigued, and more susceptible of pain; and, besides 
this, it is more liable to suffer from any causes 

m 

which would impair its soundness or diminish its 
vitality. The contagion of disease, the infection 
of fever, whatever may bring on disorder, act more 
readily and powerfully on the hungry, and on those 
who are badly nourished, than on those who are 
well fed. We are better able to resist the influ¬ 
ence of cold and to maintain the natural temper- 


Facts and Fallacies . 185 

ature of the body, when we are full, than when 
we are fasting.” 

The mind and body both, should rest a short 
time before and after each meal, for mental and 
physical activity interferes with digestion. When 
the body is tired out or much fatigued, the stomach 
participates with the other parts of the system 
in the exhaustion, and is unfitted for the reception 
of food ; therefore a short interval, if only a few 
minutes, should be allowed before eating for repose. 
Intense mental excitement, especially anger, anxiety, 
and grief, should be avoided during meals ; but if 
the mind is lightly occupied, as in cheerful, exhil¬ 
arating conversation, it aids digestion instead of 
retarding it. 

When any portion of the body is actively exer¬ 
cised, the whole system is taxed to sustain it; 
therefore if full, vigorous action be attempted in 
two parts of the body at the same time, they 
cannot be sustained ; one or the other will fail, 
or both be imperfect. After a hearty meal, when 
the stomach is full, one feels rather indisposed for 
a short time; active work is then more difficult 
to perform, and we naturally prefer to postpone 
labor either mental or physical until the digestive 
process is partially over. An experiment has been 
tried with two dogs. They both were given a 
hearty meal, then one of them confined to its 
kennel and the other put upon the chase. They 


186 How to Sustain Life and Preserve Health. 

. were both killed after a short time, when diges¬ 
tion was almost completed in the one at rest, 
while it was not even begun in the other — the 
food having remained the same as when swallowed. 
This shows the necessity of rest immediately after 
meals, and that exercise if indulged in, should at 
first be very moderate. 

Eating too fast is almost as bad as excessive 
exercise after meals, and is one of the chief causes 
of dyspepsia. We cannot properly masticate our 
food when eating rapidly, and it is swallowed in 
large lumps ; and as these must be converted into 
chyme by the solvent properties of the gastric 
juice, and the muscular action of the stomach, more 
labor is required of the digestive organs than when 
the food is chewed fine. 

The food adapted to our wants, although simple 
in composition, varies greatly in form and gustatory 
properties, and our means to accomplish the same 
physiological end are free and extensive. The say¬ 
ing, “ variety is the spice of life,” is true as regards 
food. Although restricting the number of dishes 
at each meal, there should be a generous and 
attractive variety which should vary at successive 
times of eating, according to our means, appetite, 
and art of cooking. A moderate variety of food 
is more palatable and digestible than one or two 
kinds alone, and our appetite instinctively craves 
meat with vegetables, sweet with sour, liquids with 


Facts and Fallacies. 187 

excessively dry food, etc. The kind and form of 
food best adapted to supply the wants of the body 
vary, as previously stated, with each individual. 
No one rule of diet can apply to all. The nutri¬ 
tive wants of all human beings are supplied by 
what are called “food and drink;” yet nature has 
established a special law which governs the nutri¬ 
tion of each individual, and every person must 
understand its general principles in determining 
what food and drink are best adapted to supply 
the wants of their own body. This law is founded 
upon age, sex, habits, climate, etc. When there 
is a vast difference in people, in their mode of 
life, and in their surroundings, there is a corre¬ 
sponding difference in the food and drink best 
adapted to their health and well-being, and every 
individual, therefore, has nutritive wants peculiar 
to himself. 


IV.— ALCOHOLIC drinks. 


Their Composition , and their Medicinal , Pleasing and 
Poisonous Effects. Alcohol, the essential ingredient 
of alcoholic drinks, is a colorless, volatile liquid, 
having a burning taste, and an agreeable, well- 
known, .spirituous odor. Its chemical composition 
is carbon, hydrogen and oxygen, and when it is 
absolutely pure it cannot be frozen at any known 
temperature. It is very combustible, burning with 
a bluish-white, non-luminous flame producing intense, 
heat but no smoke. 

Alcohol, absolutely pure, is seldom met with; 
it attracts water, combines with it in all propor¬ 
tions, and when the two are mixed, an elevation 
of temperature is observed, and the bulk of' the 
resulting liquid, when cooled, is less than that of 
its components. It is often important to know 
the amount of alcohol contained in a mixture; 
therefore an instrument called the alcoholmeter, 
a modification of the hydrometer, has been constructed, 
by means of which it can be easily and accurately 
determined. 

Alcohol is officinal in the United States Phar¬ 
macopoeia as Alchohol fortius , specific gravity 0.817, 


Their Composition and Effects. 189 

which contains 92 per cent, of alcohol ; Alcohol , 
specific gravity 835, 85 per cent ; and Alcohol dilu- 
tuniy made by diluting alcohol with an equal 
measure of distilled water, specific gravity 0.941, 
39 per cent. Besides the specific gravity of the 
different officinal alcohols shown by the alcoholmeter, 
their purity is determined by their odor, misci¬ 
bility with water, complete volatility, and their 
behavior to nitrate of silver. 

Alcohol is a solvent of great value. It is 
employed in the manufacture of alkaloids, and other 
proximate principles, of resins, numerous extracts, 
some plasters and chemicals. It usually exerts 
but little chemical action upon the substances 
which it dissolves, and is easily expelled by a 
gentle heat, owing to its volatility, leavdng the 
substances which it previously held in solution 
in a pure state. Alcohol is also a permanent 
ingredient of all spirits, tinctures, most fluid extracts, 
some mixtures, solutions, liniments, a few infusions, 
wines, syrups, etc. 

Alcohol may be obtained by subjecting to distil¬ 
lation any saccharine solution (solution of sugar) 
that has undergone fermentation. It is usually 
obtained from corn, rye, potatoes, and other starchy 
substances which require to be mashed , during 
which process the starch is converted into sugar 
by the gluten contained in the substance used or 
by the diastase of malt added with this object in 


190 


Alcoholic Drinks. 


view. After the starch is converted into sugar, 
fermentation will speedily set in on the addition 
of yeast if the temperature be kept within the 
limits of sixty-five degrees and eighty-two degrees F. 
When the temperature is too low, fermentation 
proceeds slowly, and when too high, mucilage and 
lactic acid are apt to be formed. There should be 
about one part sugar to four of water. Too large 
a quantity of sugar arrests fermentation, as the 
alcohol formed destroys the vitality of the yeast 
plant. After the solution has undergone fermen¬ 
tation, absolutely pure alcohol may be obtained by 
careful and repeated distillation and the adoption 
of methods where substances are used which 
completely separates the water from the alcohol. 

Alcoholic drinks are composed of alcohol, water, 
and various accompanying substances, such as 
sugar, acids, ethers, volatile oils, albumen, tannin, 
bitter extractive matter, coloring matter, etc. 
There are different ingredients in the different 
drinks, but alcohol and water form their great 
bulk. The quantity of alcohol varies in them 
from one to fifty-six per cent. 

Cider, beer, and ale, contain from one to ten 
per cent, by volume, of absolute alcohol. Wine, 
the fermented juice of grapes, contains from five 
to twenty per cent, of alcohol. Brandy made by 
distilling wine, contains from forty-eight to fifty- 
six per cent., and whiskey obtained from fer- 


Their Composition and Effects. 191 

mented grain by distillation, contains the same 
quantity. 

The value of alcoholic drinks does not depend 
merely upon the quantity of alcohol they con¬ 
tain, but upon their flavoring ingredients and 
various substances which modify the effect of 
alcohol upon the system. The peculiar effects 
of a given quantity of wine, for instance, differs 
greatly from that produced by an equal quantity 
of water containing a like percentage of alcohol. 
The effect of the many different varieties of 
alcoholic drinks varies in accordance with their 
constituents; and the effect of the same drink 
varies with different persons. 

Alcoholic drinks are familiar to every one as a 
remedy for debility. Wine has been used both 
as a medicine and as a beverage, from the 
earliest time known, and the first sin committed 
after the deluge was drunkenness. The physio¬ 
logical action of wine is described in the National 
Dispensatory , as follows : 

“Wine, including all forms of genuine wine, is 
essentially a stimulant of the nervous and cir¬ 
culatory systems; but its mode of stimulation is 
quite unlike that of alcohol. In due proportion 
it gives to all the faculties increased activity and 
freedom of action, quickening and brightening 
the intellect and imagination, warming the feel¬ 
ings, invigorating the digestive powers, and 


192 


Alcoholic Drinks. 


diffusing a cordial satisfaction throughout the 
whole being. Distilled spirits, on the other hand, 
tend to benumb the faculties even while stimu¬ 
lating them, so that they seem to be struggling 
under a brute force; the exhilaration they produce 
is usually fierce or maudlin, and they leave 
behind them a dull and inert dejection. As 
already stated, the peculiar effects of wine are 
due to the salts, acids, sugar, and, above all, the 
ethereal elements in which it abounds, and which, 
while they tend to mitigate the anaesthesia pro¬ 
duced by the alcohol of the liquid, insure a more 
rapid discharge of this substance from the system. 
In excessive doses, the effect of wine resembles 
more nearly those produced by distilled spirits; 
yet even these are less extreme and debasing. 
Its habitual use is conducive to the health of 
those who drink it in moderation, and is the 
best corrective of the brutality and preventive of 
the crime which everywhere attend the con¬ 
sumption of ardent spirits. The very quantity of 
it required to produce intoxication, tends to limit 
the mischiefs of its excessive use; and, even when 
‘the sweet poison of the misused wine’ is 
indulged in beyond measure, its mischievous influ¬ 
ence upon the health is less than that of alcohol; 
for while the latter tends directly to occasion 
fatal disease of the liver, heart, and kidneys, the 
intemperate use of wine is more apt to engender 


Their Composition and Effects. 193 

gout, gravel, and nervous affections. Even these 
results are rarely attributable to some of the 
sorts of wine which are most largely used, as the 
Rhenish, Bordeaux, and most Italian wines.” 

Pure wines, unfortunately, are difficult to obtain, 
for most of those in the market are adulterated, 
and many of them are even made artificially. 
Dishonest dealers frequently mix alcohol with 
water, and add poisonous ingredients, to give the 
mixture the flavor of the wine, or any other 
alcoholic drink that they desire to imitate. 

Genuine brandy of good quality is also difficult 
to obtain. The true article, that made from wine, 
has qualities peculiar to itself. It is not only 
more palatable, more cordial to the stomach, but 
produces a more grateful exhilaration than any 
other distilled spirit. 

Lager beer and whiskey, however, are more 
extensively used in the United States than other 
alcoholic drinks. Probably this is because they 
are comparatively cheap, and because pure wine 
and brandy are not readily procured. Lager beer 
makes a man corpulent, and gives him a coarse, 
gross appearance, and as a stimulant it has no 
virtues when compared with a good pure wine. 
Whiskey is spoken of in the National Dispensatory 
as follows : 

“ The action of whiskey, both immediate and 
remote, differs in many respects from that of 


194 


Alcoholic Drinks. 


brandy; and the former liquor made from rye is 

not identical with that distilled from wheat; nor 

are potato brandy and grape brandy alike in their 
effects. Whiskey, and also gin, besides being less 
palatable, to all but the coarsest tastes, than 
brandy, are much more apt than the latter 

to produce functional and then organic disease of 
the stomach, liver, and kidneys, and their immediate 
operation is less genial and exhilarating. In the 
absence of pure brandy, whiskey is probably the 
best of the alcoholic distilled liquors, since its 

comparative cheapness in a great measure removes 
the temptation of dealers to adulterate it.” 

People may be divided into four classes, and the 
views of each class in regard to the use of 
alcoholic drinks, differ greatly. There is the 
teetotaler, the occasional moderate drinker, the 
habitual moderate drinker, and the drunkard. 
The teetotaler firmly believes that it is best for 
the human race to entirely abstain from all fer¬ 
mented and distilled liquors. They “ touch not, 
taste not, and handle not,” and many of them are 
so radical in their views that they would not 
take a drop of alcoholic liquor even as a medicine 
in sickness. 

Proper encouragement should be given the spirit 
of self-sacrifice for the good of others, and we 
highly honor those who from conscientious 
motives, and for the supposed good of their 


Their Composition and Effects. 195 

fellows, take the pledge of total abstinence; but 
th£ advocates of teetotalism, although accomplish¬ 
ing much good, frequently do unintentional harm. 
The terrible evils resulting from the excessive use 
of fermented and distilled liquors should be 
avoided; alcoholic drinks should not be used 
habitually as a beverage, but their proper and 
judicious use should not be discountenanced and 
prohibited. 

Teetotalers think only of the thousands of 
people who, through the excessive use of ardent 
spirits, are in almshouses, asylums, jails, and 
prisons; and of the idleness, poverty, disease, and 
crime of the unfortunate men and women before 
finding a home in these places. They therefore 
regard all forms of alcoholic drinks merely as 
stimulants which develop vagabonds, ruffians, black¬ 
legs, gamblers, robbers, incendiaries, and murderers, 
and incites them to go to extremes in their 
infamous crimes. They believe in total absti¬ 
nence because they view the subject only in this 
light; but this is as little an argument in favor 
of general teetotalism, as if some one were to 
assert that because fire when not properly used 
and controlled is a very destructive agent, and 
that, therefore, we should abstain from the use 
of fire. 

The occasional moderate drinker uses alcoholic 
drinks as a medicine, but not as a beverage ; as an 


196 


Alcoholic Drinks. 


exhilarating stimulant to rally his vital energies 
when on the eve of exhaustion, but not as a mere 
pleasing cordial ; or in other words, he uses them 
for their effect, but not for their taste. We all 
require the occasional use of stimulants in some 
form or other, and every person uses them ; some 
prefer alcoholic, some tobacco, some tea, some 
coffee, etc., etc. Alcoholic drinks exercise a pecul¬ 
iar fascination to those familiar with their pleas¬ 
ing effects, when under the pressure of worry and 
mental dejection. 

Teetotalers, so called, who abstain from the use 
of alcoholic drinks, even the occasional moderate 
use in their mildest form, use tea, coffee, tobacco, 
or other substances. They not only use their 
favorite stimulant when they feel inclined, but fre¬ 
quently use it in excessive and poisonous quantities. 

Stimulants are necessary to happiness, health, 
and life, for all organs of the body live by stimuli, 
which in temperance animate, and in excess destroy. 
The stimulus of the eye is light, but its intensity 
will destroy sight. The stimulus of the ear is 
sound, but too loud a noise deadens hearing and 
causes deafness. The various organs of the body 
fail when the stimulants required for their exist¬ 
ence are withdrawn or received in excess. Tem¬ 
perance, not abstemiousness, prolongs life. Happi¬ 
ness is conducive to health, but joy will kill by its 
excess and suddenness. 


Their Composition and Effects. 197 

Mental anxiety causes the nervous system to 
become depressed and exhausted, and to avoid 
sickness, the flagging and worn-out nerves require 
some form of stimulant to rally their vital ener¬ 
gies. When we are exposed to cold wet, and suf¬ 
fer hardships, mild stimulants minister relief and 
preserve health. The reason why alcoholic drinks 
are such a terrible devastator, is because people 
use them as a beverage instead of a medicine. In 
moderate doses they stimulate, but in excess they 
destroy. Their temperate use benefits the nerves 
in times of depression, but their excessive use 
disorganizes their functions. 

The moderate use of alcoholic drinks in time of 
need softens our nature and makes us more kind- 
hearted and benevolent than our cold reason would 
naturally let us be. They give us warmer emo¬ 
tions and larger sympathies, and make us more 
friendly, social, and courteous than perpetual sobri¬ 
ety will permit us to indulge in. They will also 
stimulate thought, and reveal men’s intellectual 
powers which may be slumbering within them, and 
will show to age, by occasions, that its youth still 
lies within it. 

These are the pleasing effects of alcoholic drinks, 
and in them lies man’s danger. People become 
fascinated and drink to excess ; then there is over- 
stimulation, and the brain becomes befogged. The 
intellectual faculties are disturbed, or there is intel- 


198 


Alcoholic Drinks. 


lectual drowning, so to speak, and the animal, instead 
of the intellect, controls the victim. 

The habitual moderate drinker who uses alcoholic 
drinks daily as a beverage, destroys his health and 
shortens his life, perhaps, without even suspecting 
it. He is secretly establishing disease, and his 
stomach, liver, kidneys and brain, will successively 
become deranged, and the diseased condition will 
cause him much annoyance and hasten his death. 
Alcoholic drinks of good quality when taken occa¬ 
sionally in small doses aid digestion, but when 
used habitually, or when taken in excessive quan¬ 
tities, they disturb and arrest the digestive process. 
They act when taken in excess, as an insidious 
poison, and excite and foster disease with fatal 
pertinacy. 

The harmless or injurious effect of alcoholic 
liquors on the system is not only determined by 
their quantity, but by the skilful adulterations 
palmed upon us as genuine articles. Those who 
drink fermented and distilled liquors, usually have 
neither the knowledge nor the means of testing 
them before drinking; and frequently their taste 
is so accustomed to the poisonous compounds that 
it is perverted and they prefer the adulterations 
to the healthy produce. 

The drunkard has become so fascinated with 
the pleasing effects of alcoholic liquors that he 
drinks to excess. He feels at times- an almost 


Their Composition and Effects. 199 

insatiable craving for ardent spirits, and indulges 
in them in repeated and increased doses. Probably 
he never intended to drink sufficiently to bring 
him to that state known among drunkards as 
“the horrors,” but through habitual and excessive 
use of stimulants, he has become so diseased that 
his only object in life is to gratify his morbid 
craving for alcohol. The physiological effects of 
the excessive use of alcohol are described in the 
National Dispensatory , as follows : 

“ Habitual excesses, according to the form and 
quantity of the alcohol consumed, tend to increase 
fat, and diminish muscular tissue, and to render 
the capillary bloodvessels everywhere turgid, giving 
to the skin, especially of the face, a puffy and 
purplish look. The digestion becomes impaired, 
the nervous system unsteady, the gait loses its 
elasticity, the hands grow tremulous, the senses 
dull, and the mind torpid; the sleep is broken, 
dreamy, and unrefreshing. After unusual excesses, 
delirium tremens is apt to occur, and habitual f 

i 

drunkenness, sooner or later, in many cases,' 
induces a state of chronic imbecility, with partial 
paralysis. Fatty heart, cirroused liver, and granular 
kidneys, are frequent associated lesions, producing 
fatal dropsy, especially if distilled liquors have 
been employed, while gout is a more usual result 
of intemperance in wine.” 

The average expectation of life of an individual 


200 


Alcoholic Drinks. 


twenty years of age, who has intemperate habits, 
is only fifteen years, provided he does not reform ; 
but it is very difficult to convince a young man 
of the fact. The habitual drinker is so fascinated 
with his beverage, that he cannot realize the 
danger to his health and life, and it is almost 
impossible to convince him before degenerative 
changes occur in his body. His repentance 
then comes too late, for years of the most com¬ 
plete abstinence will scarcely suffice to restore 
his health. 

Persons with feeble stomachs from deficient 
gastric secretion, may be benefitted by taking 
with their meals a small quantity of mild wine, 
which stimulates the stomach to pour out a more 
copious solvent, and thus promote digestion; but 
in health the stomach is thus made to digest 
more than the body requires, and in this way many 
persons get an excess of fat. Those in health who 
use alcoholic drinks, should use great care and 
remember that their habitual use gives them a con¬ 
stitution of a peculiarly treacherous character. 
Their apparently robust health will vanish with 
unusual rapidity when attacked by any acute 
disease. 

If young men would abstain entirely from alco¬ 
holic liquors, and also tobacco, tea, and coffee, 
until the age of twenty-five, drunkenness would 
be almost unknown by the next generation, for 


Their Composition and Effects. 201 

intemperance is usually the result of habits formed 
in youth. It is worse than foolish for young 
people to use these stimulants when they are not 
sick, and their use is nothing more than a mere 
cultivated habit. 

Youth is ambitious and full of hope, which 
promises happiness, honor, and fame. The nervous 
system of youth does not require stimulants, for 
it is not exhausted by trouble, unrealized wishes, 
or blasted expectations. Middle life, however, 
brings with it its doubts, troubles, and afflictions, 
its aspirations chilled by experience, and, when 
battling with stern realities, there may be times 
when stimulants are of actual benefit. Organs 
below par, from debility, may be brought up to 
a nominal tone by their use in time of need, 
provided they are not used to excess. 

No fixed rule can properly guide a person in 
the use of stimulants. Established facts and 
individual experience must be taken into con¬ 
sideration, and “in all these matters,” says Dr. 
Beard, “each one must work out his own salva¬ 
tion with fear and trembling.” The same author 
in his Home Physician says : “ If you find by 
experience that you are positively benefited by 
any one of these stimulants or narcotics, then 
use it with the same judgment and moderation 
that you would use any article of food on your 
table. 


202 


A Icoliolic Drinks. 


“ If you find that you are becoming a slave to 
any one of these substances, disentangle yourself 
and make yourself master of the situation at all 
hazards, and at whatever cost. You may know that 
you are abusing your favorite stimulant — be it 
tea, coffee, tobacco, or alcohol — when you find 
that you are such a slave to it that you cannot 
possibly do without it. 

“ If, on the other hand, you find by experience 
that you are injured by any stimulant or narcotic 
that you may be in the habit of using — no 
matter how moderately — drop it as you would drop a 
hot coal, and never give it another thought, even 
though you see your friends about you on every 
hand using the same substance even more freely 
than yourself, not only without injury, but with 
real apparent benefit. In these matters every man 
must be a law unto himself.” 

The great antidote to intemperance and drunk¬ 
enness is reason, education, and common sense. 
Most drunkards are either ignorant or low born 
persons. Although intelligent and educated people 
frequently use stimulants to excess, there is not 
as much gross intemperance among them as 
among the uneducated and low classes. The 
intemperance of the poor and ignorant, although 
often the cause of their unfortunate circumstances, 
is more frequently the result of their depressed 
condition. 


203 


Their Composition and Effects. 

The poor man may have but a slender meal, 
and by means of stimulants his deficient food is 
made to last him a longer time, although of course 
at the expense of his body; but he cannot com¬ 
prehend it. Those people who are deficient in 
mental and moral training, when driven to the 
bar-room by hunger, thirst, or debility, have not 
sufficient moral force to stop drinking when the 
demands of nature have been supplied, and as a 
result, drunkenness with all its evils follow. 

“ Intemperance not only destroys the health, 
but inflicts ruin upon the innocent and helpless, 
for it invades the family and social circle, and 
spreads woe and sorrow all around; it cuts down 
youth in all its vigor, manhood in its strength, 
and age in its weakness; it breaks the father’s 
heart, bereaves the doting mother, extinguishes 
natural affection, erases conjugal love, blots out 
filial attachment, blights parental hope, and brings 
down mourning age in sorrow to the grave. It 
produces weakness, not strength; sickness, not 
health; death, not life. It makes wives widows, 
children orphans, fathers friendless, and all of 
them at last beggars.” — Gunn's New Domestic 
Physician. 

Teetotalism, or total abstinence, is a needed 
straight-jacket for the confirmed drunkard, and for 
all persons that are too emotional, and lack judg¬ 
ment, reason, or self-control. Many persons are 


204 


Alcoholic Drinks. 


so constituted that they cannot use alcoholic 
stimulants without using them to excess. They 
frequently wish to discontinue their use, and per¬ 
haps do so for a short time, but when their 
morbid craving for them returns, they again 
drink to excess. 

It is a very difficult matter to suddenly give 
up the use of stimulants when the habit of 
using them has been gaining strength for a long 
time, but a drunkard cannot “taper off;” the 
only way he can reform is to abstain entirely 
from alcoholic drinks. If he takes one glass, he 
will crave more, and will get drunk again. 

If he really wishes to reform, he should care¬ 
fully think the matter over until there is no 
lingering doubt in his mind about the injury 
alcoholic drinks are doing him. He should under¬ 
stand the reason, and all the reasons, why they 
are not good for him. Then he should avoid the 
thoughts, the persons and the places that lead 
to the temptation to drink, and should frequent 
the places, associate with the persons, and indulge 
in the thoughts that lead away from the tempta¬ 
tion. He should keep busy at something that 
will occupy his close attention, and not become 
discouraged and give up the struggle, even 
though he should break his resolution time after 
time. When the resolution has been broken, he 
should think the matter over carefully until he 


Their Composition and Effects. 205 

understands why he failed, so that he may be on 
his guard against a recurrence of the same cir¬ 
cumstances. The harder and more difficult it 
is to reform, only shows the greater necessity for 
reforming. 


V. — NARCOTICS. 


Narcotics are substances which in medicinal doses 
act as an opiate or anodyne, allaying pain, morbid 
sensibility, and producing sleep, but which in poi¬ 
sonous doses impair or destroy nervous action, 
causing stupor, coma, convulsions, and frequently 
death. The primary effect of most narcotics is 
of a stimulating character, which is manifested 
principally when they are taken in small doses. 

The general action of narcotics is modified by 
a great variety of circumstances. ' Some persons 
can take them in full doses without unpleasant 
result, while others are nauseated, excited and 
stupefied by the smallest quantity. The power 
of narcotics is diminished in a remarkable degree 
by repetition. Opium eaters, therefore, find it 
necessary to gradually increase the quantity of 
opium that they use, in order to obtain the same 
effect. The climate or season also influences their 
action, larger doses being required in cold weather 
than in warm. Among the principal narcotics are 
opium, belladonna, conium, stramonium, hyoscya- 
mus, lactucarium, aconite, extract of hemp, hops, 
lobelia, tobacco, etc. 

?o§ 


Opium — Its Use and Abuse. 207 

Opium — Its Use and Abuse. Opium, the most 
energetic of narcotics, is the inspissated juice of 
a species of poppy, originally a native of western 
Asia and southeastern Europe, where it is found 
wild in fields and waste places. It is now natural¬ 
ized in several countries, and is cultivated exten¬ 
sively in India, Turkey, Persia, China, Japan and 
Egypt for the production of opium, and as an orna¬ 
ment in gardens. The poppy has also been cul¬ 
tivated in the United States, and opium of fair 
quality, but in limited quantity, has been produced 
here. 

Opium is procured by making superficial incis¬ 
ions in the green capsule of the poppy, in the 
evening, and the milky juice which exudes is ready 
for collection the next morning, when its color 
will have changed from white to brown. The 
numerous small seeds within the poppy capsule 
are destitute of narcotic properties. 

The opium in the market is of dense consistency, 
brown in color, and has a peculiar strong aromatic 
odor. It becomes harder and darker with age, 
and has a bitter, acrid, and nauseous taste. It 
contains a great variety of chemical constituents, 
the most important of which is the alkaloid mor¬ 
phia, which exists chiefly in combination with me- 
conic acid, an inert ingredient. 

Morphia is a powerful sedative, and is the prin¬ 
ciple upon which the narcotic effects of opium 


208 


Narcotics . 


essentially depend. Morphia occurs in colorless 
rhombic crystals, inodorous, very bitter, and as 
it is not very soluble, is not employed medicinally 
except in combination with acids which form salts, 
the effects of which are nearly identical with the 
alkaloid itself. 

The acetate of morphia, the muriate of morphia, 
and the sulphate of morphia are more generally 
used than any of the other salts of the alkaloid, 
and are all freely soluble in water. The sulphate 
of morphia, however, is used in preference to the 
acetate or muriate. 

The salts of morphia possess the anodyne, hyp¬ 
notic, antispasmodic, and diaphoretic properties of 
opium, and are considered less apt than the crude 
drug to produce unpleasant effect. They are espe¬ 
cially adapted to the hypodermic and endermic 
methods of application which are resorted to when 
prompt action of the medicine is necessary to lessen 
pain or save life, and also when the patient is un¬ 
able or unwilling to swallow. 

Opium is one of the most valuable drugs in use, 
and it, or its alkaloid morphia, is the active ingre¬ 
dient of a large number of important medicines; 
as an anodyne it relieves pain and allays nervous 
irritation; as a hypnotic it produces sleep, and is 
positively contraindicated only where there is a ten¬ 
dency to apoplexy or coma, or where there exists 
an idiosyncrasy in regard to its effects, It is 


Opium — Its Use and Abuse. 


209 


also used as a stimulant in low fevers, as an 
arrester of secretion in diarrhoea, and as a diaph¬ 
oretic in various conditions of the system. Opium 
is the great cough-relieving remedy, and most 
cough mixtures contain it in some form or other. 

When opium is taken in medicinal doses, it 
moderately excites the circulation, increases the 
temperature of the skin, and produces that state 
of mind in which there is an agreeable indiffer¬ 
ence to everything. This is soon followed by 
diminished sensibility, drowsiness, sleep and dimi¬ 
nution of all the secretions except that of perspi¬ 
ration, which is increased. In larger doses the 
first symptoms may be so transient as not to be 
noticed ; then the mind becomes confused, and there 
is more or less complete unconsciousness, with 
slow stertorous breathing, very contracted pupils, 
slow, full pulse, and more or less lividity of the 
countenance. Nausea and vomiting are produced 
in some persons After the deep sleep or coma 
produced by an over-dose, the return to conscious¬ 
ness is attended with depression of mind and 
body, headache, nausea, and constipation. When a 
fatal dose has been taken, the ordinary symptoms 
produced by the drug are intensified, the face 
becomes pale and cadaverous, the pulse sinks, the 
muscular system becomes relaxed, and coma con¬ 
tinues until death, which is sometimes, especially 
in children, preceded by convulsions. 


210 


Narcotics . 


Opium is usually prescribed in the form of 
powder, or tincture (laudanum), or camphorated 
tincture (paregoric), but there are many other 
officinal preparations of opium in daily use. The 
habitual use of the drug in any form is attended 
with very pernicious effects, and it is to be 
regretted that the number of “opium eaters” in 
the United States has increased during the past 
few years ; not only among residents of foreign 
birth, but among native born Americans. 

The habitual use of opium or morphine, like 

the excessive use of alcoholic liquors, ruin a man 
financially, morally, and physically, but opium 

eating is by far the greatest of the two evils. 
It is difficult for a drunkard to reform, but it is 
infinitely more difficult for a confirmed opium 
eater to reform, and it is very rare that one does. 

Opium eaters not only use the drug in both 

solid and liquid form, but many addicted to its use 
have the equally pernicious habit of smoking it. 

The injurious and fatal habit of opium eating 
is sometimes contracted by using the drug regu¬ 
larly day after day to relieve excruciating pain, 
but many persons, especially opium smokers, delib¬ 
erately, foolishly and recklessly, place themselves 
in bondage from which as a rule, they are only 
relieved by death. 

Those who use opium are at first fascinated 
with its pleasing and soothing effects, but after 


Opium — Its Use and Abuse. ; 

a time the feeling of complete satisfaction fails to 
appear when the drug is used. They continue 
their ruinous habit, however, for should they 
attempt to abandon it, they experience such terrible 
suffering and intense craving for the drug that 
they appear to suffer the agonies of a thousand 
deaths without it. 

A few persons addicted to the use of opium 
have discontinued the habit after an intense and 
prolonged struggle, by gradually diminishing the 
quantity of the drug consumed and substituting 
for it aromatic and astringent tonics. This is 
the secret of many so-called opium cures or 
antidotes. Another method of curing the habit con¬ 
sists in its abrupt cessation, but the number of 
inveterate opium eaters who reform is very small. 
The only absolutely certain way of avoiding its 
disastrous and ruinous effects is not to commence 
its use, and thus not get within its fatal fasci¬ 
nating power. 

Tobacco-Smoking, Chewing and Snuffing. To¬ 
bacco was used by the natives of Cuba, by 
smoking cigars when the island was discovered in 
1492; and pipe smoking was, probably, common 
among the aborigines of this continent long before 
its discovery. Sir Walter Raleigh on his return 
from an expedition to colonize America, introduced 
tobacco into England from Virginia, in 1586, since 
which time the habit of smoking, chewing, and 


2 


Narcotics. 


snuffing, has rapidly spread over -the whole world. 

Tobacco was not used in Europe until after 
the discovery of America, and soon after its appear¬ 
ance there its use was prohibited in many parts. 
Priests denounced its use as sinful, and physicians 
declared it hurtful to health. Pope Urban VIII. 
issued a bull excommunicating all persons found 
taking snuff while in church, and smoking was 
made a capital offense by one of the Sultans of 
Turkey. In Russia the penalty paid for smoking 
was to have the nose cut off, and King James I. 
used his best endeavors to suppress the use of 
tobacco in England. 

Tobacco is a virulent poison, but notwithstanding 

a 

its dangerous and destructive properties, and all 
the opposition to it in the past, the habit of 
using it, at the present time, is universally prev¬ 
alent : and the tobacco plant is very extensively 
cultivated in most temperate and subtropical 
countries. There is no stimulant or narcotic that 
is used as extensively as tobacco, and the exces¬ 
sive use of the noxious weed among the educated 
men of our day, does more harm than the exces¬ 
sive use of alcoholic stimulants among the same 
class of men. 

Nicotia, the poisonous principle of tobacco, is 
hostile to all forms of life, and it stands next 
to prussic acid in the rapidity and energy of its 
poisonous action. When taken into the human 


Tobacco-Smoking, Chewing and Snuffing . 2 ^ 

system in small doses, it produces a hot, burn¬ 
ing sensation in the mouth, a feeling of rawness 
in the throat, and profuse salivation. A sense of 
heat quickly appears in the stomach, chest, and 
head, followed by nausea, vomiting, purging, gid¬ 
diness, torpor, indistinct vision, sleepiness, imper¬ 
fect hearing, laborious and oppressed breathing, 
and dryness of the throat. Symptoms of great 
prostration soon appear, the nervous system 
becomes deranged, the pulse rate falls, the muscles 
become relaxed, the surface of the body cold, the 
face pale, the head droops, and faintness ends in 
loss of consciousness. When a little larger dose 
of nicotine is taken it produces an intensification 
of these symptoms with rapid death, or the poison 
may kill the victim in a few minutes, before the 
symptoms become developed. The physiological 
action of tobacco when taken into the stomach, 
is nearly identical with that of its active poisonous 
ingredient, nicotiana, just described. 

Tobacco also contains an oil which is generated 
only in combustion, and accumulates in old pipes. 
It is a virulent poison, even when applied to 
eruptions on the skin, and a few drops of it 
taken into the human system, rapidly destroys 
life. In very small doses, its immediate effects are 
pallor, vertigo, faintness, nausea, vomiting, cold 
sweating, diarrhoea, and paralysis of the lower 
limbs. 


Narcotics. 


J *4 

Persons learning to smoke or chew tobacco, 
usually poison themselves to a gi eater or less 
extent in their first trials. The usual results of 
the first attempts to smoke are, nausea, giddiness, 
vomiting, or a feeling of deathly sickness, with 
cold sweatings and very feeble pulse. 

The use of tobacco by young boys, or those 
who have not attained their full growth, is attended 
with the most pernicious results. Tobacco not only 
hinders the growth and development of the body, 
but deranges the nervous system, and impairs the 
eyesight and hearing; and the depressing influences 
of the insidious poison seriously damages the 
intellect. 

The filthiness of smoking, chewing and snuffing, 
and the unpleasantness arising from the use of tobacco, 
are well known. Snuffing not only impairs the sense 
of smell and voice, but a snuffer is recognized by a 
certain nasal twang or asthmatic wheezing. Smoking 
is less filthy than chewing, but its influence on the 
system is as pernicious. 

An inveterate user of tobacco must subject his 
system to the influence of tobacco at certain inter¬ 
vals, or he experiences an intense and peculiar crav¬ 
ing which soon becomes an irresistable desire for 
the noxious weed. It is as difficult for an old 
smoker, or chewer, or snuffer, to discontinue the use 
of tobacco, as it is for a man accustomed to the 
use of alcoholic stimulants, to give up the use of 


Tobacco-Smoking , Chewing and Snuffing. 215 

his favorite stimulant if helped by a powerful will. 

The writer has never used tobacco in any form, 
and cannot speak of its physiological action from 
personal experience, therefore he will not attempt 
to portray the evil effects of smoking, chewing, or 
snuffing, but will take a condensed statement of 
these evils from the National Dispensatory , a 
standard authority, as follows: 

“ Tobacco lessens the natural appetite, more or 
less, impairs digestion, and induces constipation; 
while it irritates the mouth and throat, rendering 
it habitually congested, and destroying the purity 
of the voice. It induces an habitual sense of 
uneasiness and nervousness, with epigastric sink¬ 
ing or tension, palpitation, hypochondriasis, neu¬ 
ralgia, and frequent urination. Chewing and snuffing 
tend to cause gastralgia, but smoking neuralgia of 
the fifth pair. It renders the vision weak and 
uncertain, causing objects to appear nebulous, or 
creates muscae volitantes, and similar subjective per¬ 
ceptions. In numerous instances it has produced 
amaurosis. Similar derangements of hearing occur, 
with buzzing, ringing, etc., in the ears, and even hal¬ 
lucinations of this sense. Often there is a feeling of 
a rush of blood to the head, with vertigo, and impair¬ 
ment of attention so as to prevent continuous mental 
effort; the mind is also apt to be filled with crude 
and groundless fancies, leading to self distrust and 
melancholy. The sleep is frequently restless, and 


216 


Narcotics. 


disturbed by distressing dreams. It impairs muscular 
power and coordination, probably both, by inter¬ 
fering with nutrition, and exhausting nervous force, 
and usually keeps down the growth of muscle, and 
the deposit of fat. Doubtless there are many per¬ 
sons who use tobacco in one or more forms, who 
experience few or none of these evils, and whose 
constitutions seem proof against its mischievous 
effects; but to the greater number, the habitual 
use of it is more injurious than useful, and it acts 
upon a certain number, in almost all doses, as a 
poison.” 


PART III. 

MEN AND WOMEN. 

HOW TO AVOID THEIR AFFLICTIONS AND 
SUSTAIN THEIR LIVES. 



INTRODUCTION. 


Men and women are liable to innumerable afflic¬ 
tions during the whole period of their existence. 
They commence at birth and terminate in death. 
Their effects — annoyance, pain, disease, injury and 
death—vary with their severity and with the 
power of resistance in the body. 

If all the organs of the body would work to¬ 
gether harmoniously until the vital forces are 
exhausted, the human structure would wear out 
by general decay rather than the giving out of 
any particular part of the system; but the afflic¬ 
tions to which we all are subject destroy some 
vital part of our organism, and premature death 
follows. 

Most of the ills which afflict us, and rob us 
of so much enjoyment, and cause us so much 
misery and shorten our existence, can easily be 
avoided with a proper knowledge and observance 
of hygienic laws. 


219 


I. — DISEASE. 


Disease, the reverse of ease, is known by com¬ 
paring it with the standard of health from which 
it is a departure. 

When the fluids of the body are in no respect 
abnormal, and all the tissue and organs have 
their normal integrity and properties, and all the 
functions of the organism are completely and 
harmoniously performed, perfect health exists ; 
but this perfection of health is but very rarely, 
if ever, obtained by human beings. We all 
violate the law of health in some way or other; 
we abuse or misuse our powers, or we neglect 
to supply all our actual wants, or we are unable 
to resist the destructive forces with which we 
come in contact, and the penalty of a violated 
law follows as necessarily as an effect follows a 
.cause. 

Disease is discord, while health is concord. 
When either the functions or any part of the 
structure of the human body is deranged, we are 
sick. Disease of function is known by its devia¬ 
tion from a physiological standard, while disease 

of structure is recognized by an anatomical stand* 

220 


Knowledge of the Causes of Disease . 


221 


ard. These varieties of disease are commonly 
combined. Functional disease is often accom¬ 
panied and always followed by change of struct¬ 
ure, and structural disease without functional dis¬ 
ease is rare. 

Knowledge of the causes of disease is of para¬ 
mount importance in its prevention, management, 
and removal. The causes of disease are very 
numerous, and are divided into intrinsic or inter¬ 
nal, and extrinsic or external, according as they 
operate on the body from within or without. 

Intrinsic or internal causes are the retention of 
excreta in the system, intense or long-continued 
emotional excitement, overtaxing the faculties of 
the mind? etc. Disorders of the nervous system 
and insanity usually arise from intrinsic or inter¬ 
nal causes, such as long-continued mental depres¬ 
sion, care, anxiety and worry. Extrinsic or external 
causes are the action of poisons, venoms, miasmata 
and injuries. 

The causes of disease may again be distin¬ 
guished as ordinary and special or specific. Ordi¬ 
nary causes are those to which all persons are 
more or less exposed, as atmospherical vicissitudes, 
etc. They give rise to two or more forms of 
disease. 

Special or specific causes give rise to only one 
form of disease, and are extraordinary in their 
occurrence, as persons are exposed to them only 


222 


Disease . 


at certain times or in certain situations. Small¬ 
pox, yellow fever, scarlet fever, syphilis, etc., are 
diseases which arise from special or specific 
causes. 

Causes of disease have also been divided into 
primary and secondary. Secondary causes are those 
due to the effects of pre-existing diseases. Often 
when the kidneys are diseased, and their elimina¬ 
tive function interrupted, urea accumulates in the 
blood and gives rise to various affections. Urea 
in excess in the blood is thus a secondary cause 
of disease. 

Primary causes do not proceed from prior dis¬ 
eases, and they produce what is called primary 
diseases; while secondary causes, or those due to 
pre-existing diseases, produce what is called sec¬ 
ondary diseases or complications. 

When prescribing for the sick, it is not suffi¬ 
cient to have discovered a disease; we should 
ascertain whether one or more additional diseases 
do not exist, and which is the primary and which 
the secondary disease. To prescribe intelligently, 
a knowledge of the primary cause is essential. 

Probably the most simple division of the causes 
of disease is into predisposing and exciting. Pre¬ 
disposing causes are a liability or tendency to 
certain forms of disease. They may be sufficient 
to give rise to disease, or only suffice to place 
the system in a condition favorable for its occur- 


Knowledge of the Causes of Disease. 223 

rence. Exciting causes create disease when act¬ 
ing on persons already predisposed to them. 

Predisposing causes of disease are debilitating 
influences, hereditary constitution, temperament, 
excitement, age, sex, occupation, climate, and pre¬ 
vious and present disease. Among the exciting 
causes are defective cleanliness, ventilation, and 
drainage, overwork, excessive worry, mechanical 
and chemical agents, temperature, sudden changes 
in the weather, and endemic, epidemic, and conta¬ 
gious poisons. 

The symptoms of a disease are the indications 
of it, and they embrace all the appreciable morbid 
phenomena occurring in connection with it. A 
knowledge of the symptoms of disease is essen¬ 
tial to a correct diagnosis (the distinction of dis¬ 
eases from one another), and is of the utmost 
importance in treating the sick. If we have not 
the knowledge and skill to make a correct discrim¬ 
ination of diseases, to determine their character 
and seat, we cannot intelligently manage them, 
or properly treat them. 

The prognosis of disease is an opinion as to its 
future course, changes, and termination. Patients 
and their friends often desire information concern¬ 
ing the way in which diseases are to end, and it 
is important to form correct judgment on this 
point; still, as a general rule, one should avoid 
making strong statements and confident predictions 


224 


Disease. 


regarding the death or the recovery of a patient. 

A person may be very dangerously ill and yet 
recovery be possible. But to inform such a 
person of the exact danger at such a time will 
often take away hope and cut the thread of life. 
The stimulus of hope helps sustain the feeble 
patient, and favors the return to health. On the 
other hand, when a fatal termination of a disease 
is clearly indicated, and there is no hope what¬ 
ever of life being long spared, it is a duty to 
inform the sick man of his danger, that he may 
be enabled to arrange his worldly affairs, to make 
his will, and to prepare for death. 

We should do everything possible to prevent 
disease. Many diseases are preventable by remov¬ 
ing or obviating their causes. When diseases exist 
we should devote our attention to their treatment. 
The division of medicine devoted to the treatment 
of disease is called therapeutics. 

In treating disease by what is called abortive 
measures, the object is to arrest its progress and 
restore health by cutting the malady short. Cur¬ 
ative, or remedial measures used in treating dis¬ 
ease, diminish its severity and danger, and hasten 
the return to health. Palliative measures are 
directed to the symptoms or effects of disease 
rather than to the disease itself, and are frequently 
employed with the object of temporarily relieving 
pain or suffering. Sanitary or hygienic measures 


Knowledge of the Causes of Disease. 225 

relate to pure air, cleanliness, etc. Sustaining or 
supporting measures consist of tonic remedies and 
stimulants ; and restorative or building-up measures 
relate to diet and those remedies used to bring 
the system back to its normal condition. 

Diseases may assume different forms and char¬ 
acters to those they originally presented, or they 
may give rise to other diseases, or they may leave 
a particular organ and be transferred to some other 
part by what is termed metastasis; but they all 
ultimately terminate in health or in death. 

The termination of disease in health is due to 
the subsidence of the morbid actions, and restora¬ 
tion of the vital energy. Convalescence may take 
place suddenly in some instances, but most fre¬ 
quently the change is gradual. The earliest symp¬ 
toms favorable to recovery are a diminution of 
the temperature and pulse, cleaning of the tongue, 
and a restoration of the secretions / to their nor¬ 
mal condition. 

Convalescence may go on happily or be delayed 
by unpleasant symptoms, and sometimes the cure 
is interrupted by a return of the disease—by a 
relapse. Frequently the symptoms of an acute 
disease subsides, without disappearing, and con¬ 
tinues for a lengthened period; the disease has 
then become chronic, and may continue until 
death. 


II. — DEATH. 


Should a disease end fatally, what will be the 
mode of death ? This is a question frequently 
asked when diseases involve danger to life, and 
the following, taken from Tanner s Clinical Medicine , 
will give the reader a full and accurate descrip¬ 
tion of the termination of- disease in death : 

“ Death is the condition to which all organized 
bodies must ultimately be reduced. It may take 
place naturally and gradually from old age — from 
exhaustion of the vital forces, the active powers 
gradually deserting each organ, the functions of 
absorption and secretion being arrested, the 
general circulation becoming slowly suspended, and 
the heart ceasing to contract. Unfortunately, 
death from mere old age is very rare.” 

“ Seeing, then, that death from disease or acci¬ 
dent is the rule, it behooves us, as guardians of 
the public health, to do our utmost to remove 
the causes of disease, and to treat that which 
is unavoidable with the greatest skill and caution. 
Death from disease may take place in two ways: 
either suddenly, the transition from life to death 

being made in a moment, without warning, or 

226 


Causes of sudden Death. 


227 


slowly and gradually, as the termination of some 
lingering disorder.” 

“ The most frequent causes of these sudden 
deaths are apoplexy; rupture of an aneurism or 
large bloodvessel into one of the three great 
cavities of the body; disease of the valves of 
the heart — the liability to sudden death being 
greater in disease of the aortic valve than in 
mitral valvular disease ; rupture of the heart 
from fatty degeneration; clotting of blood in the 
heart; laceration of the chordae tendineae; asphyxia, 
from obstruction of the glottis, or the bursting of 
purulent cysts into the air-passages ; syncope, from 
severe shock or alarm; and injury to the head or 
the spinal cord.” 

si* 'l' 'X- si' .jJ/. >1/ 

/JN 'T' >T' ST* 'l" /p* 

“ Death as it occurs in disease is usually com¬ 
plicated ; but in all cases, whether it takes place 
suddenly or gradually, or whatever may be the 
malady, it approaches through one of the three 
vital organs — the brain, the heart, or the lungs. 
Life being inseparably connected with the circula¬ 
tion of arterial biood, death takes place directly 
the action of the heart is completely arrested; 
and since the action of the heart is dependent 
upon the more or less perfect condition of all 
the vital organs, which stand in a peculiar recip¬ 
rocal relation to each other, a cessation of the 
functions of either of the three speedily arrests 


228 


Death . 


the remaining two. Thus innervation of the 
muscles of respiration depends upon the medulla 
oblongata, the energy of the medulla oblongata 
upon the decarbonization of the blood, and the 
decarbonization of the blood upon the circulation 
and respiration. The force of the heart, if not 
directly, is indirectly connected with the medulla 
oblongata, because the circulation of the venous 
blood destroys the irritability of the muscles. 
And so it results that failure in any one of 
the three links in the chain is fatal. Hence 
Bichat spoke correctly of death, beginning at the 
head, at the heart, and at the lungs.” 

“We may have, then, First, Death by Syncope , 
that form which is caused by a want of the due 
supply of blood to the heart. The deaths from 
flooding after labor, from the bursting of aneurisms, 
etc., are good examples of this form ; on examining 
the heart afterwards the cavities are found empty, 
or nearly so, and contracted. Second, Death by 
Asthenia, in which there is no deficiency of the 
proper stimulus to the heart’s action — the blood 
— but a total failure of the contractile power of 
this organ. The effects of certain poisons — as 
hydrocyanic-acid, of strong mental emotion, of light¬ 
ning, a blow on the pit of the stomach, or the 
head, etc.— furnish good illustrations of this form. 
Fatty degeneration and organic disease of the cir¬ 
culatory apparatus in the chest are other causes. 


Causes of sudden Death. 


229 


Third, Death by Apnoea — or, as we say commonly, 
by asphyxia or suffocation — is that which occurs 
when the entrance of air into the lungs is in any 
way stopped, as in drowning, strangulation, spas¬ 
modic closure of the rima glottides, foreign bodies 
in the air passages. It also happens when a large 
extent of the lungs is diseased, as in severe pleurisy 
with effusion, double pneumonia, and also in those 
cases in which the reflex functions of the medulla 

0 

oblongata upon which respiration depends are 
suspended ; in those cases death begins in the 
lungs. The blood being unaerated, continues ve¬ 
nous, passes through the pulmonary veins into the 
left side of the heart, and thence through the 
arteries to all parts of the body. Venous blood, 
however, being unable to sustain the functions of 
the organs to which it is sent, its effect on the 
brain is at once seen by the convulsions and insen¬ 
sibility which ensue; the blood in the pulmonary 
capillaries becomes retarded, and gradually stag¬ 
nates, leaving the lungs and right chambers of 
the heart full and distended. In what has been 
called death by coma , the mode of dying is really 
by apnoea.” 


III. — GENERAL DISEASES. 


Morbid States of the Blood. The constituents 
and properties of the blood, the life of all flesh, 
or liquid flesh, as it is sometimes called, has been 
referred to in its appropriate place. As it is 
through the instrumentality of this vital fluid 
that the various changes which attend the phe¬ 
nomena of life are accomplished, and as it is the 
means by which the different organs and tissues 
of the body are directly nourished, it is of the 
utmost importance to health and life that it be 
kept in a state of purity. 

The blood is not only a nutrient, but it is the 
means by which used-up materials are removed 
from the system; the fluids of the body in addi¬ 
tion to the blood consist of various liquids sepa¬ 
rated or formed from it constituting exhalations, 
secretions and excretions. The non-excretion and 
consequent accumulation in the blood of excremen- 
titious substances creates disease and frequently 
causes death. 

Other causes of diseased blood are the intro¬ 
duction into the blood of morbid poisons from 

without; morbid alteration from processes occur- 

230 


Morbid States of the Blood. 231 

ring in the blood itself; and absorption of pois¬ 
onous material by the bloodvessels from diseased 
parts of the body. 

Certain morbid conditions of the blood are in¬ 
dicated by words ending in aemia. Anaemia, for 
example, means an impoverishment of the blood; 
hyperaemia, a plethora or fulness of blood; uraemia, 
a morbid accumulation of urea in the blood; 
septicaemia, putrid infection of the blood; and 
pyaemia, purulent infection of the blood. 

Anaemia, a deficiency or poverty of blood, is 
caused by deprivation of the proper materials 
necessary for its formation, as wholesome food, 
pure air, sunlight, etc., and also by exhausting 
hemorrhages or discharges. Anaemia is also inci¬ 
dent to a variety of diseases. 

In anaemia the density of the blood is dimin¬ 
ished, and there is a deficiency in the number of 
red blood corpuscles. The chief symptoms con¬ 
sist of a pale, waxy, or a sallow hue of the coun¬ 
tenance, feeble, but rapid pulse, nervousness, and 
diminished energy of mind and body. 

A peculiar form of anaemia, technically known 
as chlorosis, frequently affects young women about 
the age of puberty. A dark circle appears around 
the eyes, with ringing in the ears, lowness of 
spirits and weakness. 

Digestion is impaired, and a morbid appetite is 
sometimes present, as for coal ashes, chalk, earth, 


232 


General Diseases. 


slate pencils, and, in some cases, strong acids. 

In the treatment of anaemia, good diet, pure 
air, and tonic remedies are the essentials. 

Hyperaemia, plethora, or fulness of blood, con¬ 
sists of an excess in the density of the blood and 
in the number of red blood corpuscles; the op¬ 
posite to anaemia. The face appears full and 
turgid, with a purplish tinge, the bloodvessels 
are distended, the pulse strong and full, but rather 
slow, and there is lassitude, indolence, and a 
desire for sleep. There is a liability to headache, 
and attacks of bleeding from the nose. 

In the treatment of hyperaemia, or fulness of 
blood, alcoholic drinks should be avoided, a restricted 
diet should be adopted, and active exercise should 
be taken in the open air. 

Leucocythaemia is a morbid state of the blood 
in which the white corpuscles are greatly increased 
in number, while the red are much diminished. 
Its symptoms are debility, enlargement of the 
spleen, lymphatic glands, and frequently the liver. 
There is an unusual pallor, like that of anaemia, 
great and progressive emaciation, more or less 
swelling of the abdomen, and disordered respira¬ 
tion. Diagnosis of the disease, however, is only 
possible by microscopic examination of the blood. 
The tendency of leucocythaemia is toward death, 
and all that can be done is to put off, for a 
time, the fatal termination. Life may be pro- 


Morbid States of the Blood. 233 

longed a few years by hygienic management and 
tonic remedies, but the disease gradually ends in 
death. 

Uraemia is that condition of the blood in which 
it contains an excess of material which it is the 
function of the kidneys to excrete; the action of 
these organs being suppressed, the excrementitious 
material is retained in the blood, producing head¬ 
ache, dimness of vision, diarrhoea, convulsions, 
stupor, and death. The treatment of uraemia must 
vary with the circumstances of the production of 
the suppression. 

Many diseases involve blood changes ; and the 
morbid conditions of the blood, associated with 
general or constitutional diseases, will be referred 
to in connection with a description of the various 
diseases. 

Inflammation. A knowledge of the causes, rela¬ 
tions and effects of inflammation may be said to 
constitute the master-key to the comprehension of 
the nature of a large number of diseases. 

Inflammation is so called in consequence ot the 
acute or burning pain felt in a part affected with 
it. Every part of the body is liable to inflam¬ 
mation ; its recognized symptoms or signs are pre¬ 
ternatural redness, swelling, heat and pain. 

Inflammation is usually distinguished by partic¬ 
ular names, according to the part which is at¬ 
tacked : thus, inflammation of the pleura is called 


234 


General Diseases. 


pleuritis; of the peritoneum, peritonitis ; of the 
stomach, gastritis; and of the liver, hepatitis, etc. 

Inflammation of internal organs is detected 
chiefly by pain, increased by pressure or motion, 
and by obstruction or alteration of the functional 
action of the organ. 

The causes of inflammation are various. It may 
be produced by a mechanical or chemical irritant, 
or by the action of cold, or by some morbid 
poison received into, or generated within, the 
system. 

Inflammation may be acute or chronic; diffuse 
or circumscribed ; healthy, with a tendency to heal 
and return to the natural state; or unhealthy, 
when, on the contrary, there is a tendency to 
ulceration and gangrene. 

The redness of inflammation is caused by the 
increased flow of blood in the part affected; the 
swelling is occasioned by dilatation of the vessels 
and consequent distension of the connective tissue 
increased by the presence of exuded fluid. Inflam¬ 
matory swelling can be distinguished from oedema 
by not pitting upon pressure. The unnatural 
heat of inflammation is caused by the increased 
number of red blood corpuscles carrying oxygen 
in excess to the part affected, which develops an 
unusual amount of heat ; pain is caused by the 
pressure of the altered tissues upon their nervous 
filaments. 


Inflammation. 


235 


Inflammation may terminate in one of three 
ways; in resolution, in suppuration, or in death 
of the part. When it terminates in resolution, 
the symptoms subside and the tissues resume 
their healthy appearance. In suppuration the 
inflammation goes on, the swelling increases in 
size, and a fluid called pus, or matter, is formed 
in the centre of the inflamed tract, which after 
a time makes its escape through a natural or 
artificial opening. 

Mortification or death of an inflamed part is 
caused by the inflammatory action being too 
violent for the vital process. The pain is at first 
very severe, then the bright red color of the part 
becomes livid, vesicles form on the surface, the 
pain abates, and death of the part ensues. 

The mode of treatment of inflammation should 
vary according to the seat and character of the 
general symptoms, and consists of both local and 
constitutional remedies. 

Boils , Carbuncles , and Styes. Boils, carbuncles and 
styes are professionally called furuncular inflam¬ 
mations. 

A boil or furunculus is a circumscribed hard 
tumor which usually commences with a small red 
pimple, very painful and angry looking, and con¬ 
tinues to enlarge until it reaches the size of a 
walnut, with a white point, and a broad, hard, 
well-defined base spreading under the skin. The 


236 


General Diseases. 


point sinks as the swelling advances until the 
whole assumes the form of a flat, elevated cake 
with a puckered centre. Suppuration takes place 
slowly and imperfectly; the skin ulcerates and 
allows a little pus streaked with blood to escape; 
and then in two or three days the core is 
discharged from the centre. A boil usually runs 
its course in twelve or fourteen days. Boils may 
appear on any part of the body, but they most 
frequently form on the nape of the neck, face, 
groin, thighs, or in the armpit. Successive crops 
frequently appear in different situations, to the 
great annoyance of the patient. .Boils are efforts 
of nature to throw off or relieve the body of 
some impurity. They are caused by anything 
which leads to deterioration of the blood. In the 
treatment of boils it is necessary that the bowels 
be at first freely opened and then regulated by 
gentle unirritating laxatives. In some cases alter¬ 
ative medicines may be required. The food should 
be plain and easily digested. Poultices should be 
applied to the boil to hasten suppuration. The 
most ancient poultice that we read of was made 
of figs, and was applied to a boil when Hezekiah 
was “sick unto death,” and he recovered. ProB 
ably as good a poultice as can be obtained may 
be made of flaxseed meal or ground slippery-elm 
bark. 

A carbuncle may be considered as an aggravated 


Boils , Carbuncles and Styes. 237 

form of boil. It is usually preceded by loss of 
appetite, foul tongue, lassitude, headache, general 
uneasiness and shivering. It commences in the 
form of a pimple, and as it gradually enlarges, 
the surrounding skin becomes very sensitive, of 
a purplish tint, and burning hot ; while there is 
a severe throbbing or dull aching pain in the 
whole of the affected part. Carbuncles vary in 
diameter from half an inch to six or seven inches, 
and are most frequently situated about the nape 
of the neck or between the shoulders, but they 
may occur in any part of the body. Men are 
afflicted with them twice as often as women. 
They are caused by a vitiated state of the blood. 
The same treatment should be resorted to as for 
boils, with anodyne fomentations and such general 
remedies as the condition of the patient may 
require. 

A sty is a small boil occurring at the edge 
of the eyelid, and often originating in the follicle 
of an eyelash. It is met with usually in weakly 
children and debilitated persons. The treatment 
consists of the use of warm fomentations with a 
puncture to assist the exit of a drop or two of 
pus, if required. Tonics are usually indicated as 
constitutional remedies. 

Hemorrhage. The escape of blood from the 
vessels in which it is naturally contained, consti¬ 
tutes hemorrhage. The most common cause of 


238 


General Diseases. 


it is external violence by which the bloodvessels 
of a part are divided. (See “Wounds”). Some 
persons have what is called a hemorrhagic dia¬ 
thesis ; that is, a predisposition to hemorrhage, 
which is easily produced upon any exciting cause 
— profuse bleeding usually following the slightest 
wounds. 

Hemorrhage is often important as a symptom, 
but requires to be interpreted with care. Its 
effects vary with its quantity and source. Hem¬ 
orrhage from an artery is a continuous stream 
of bright red blood which is projected with a 
force proportioned to the size of the vessel and 
with a motion corresponding with the pulsations 
of the heart; from a vein the blood is of a 
dark crimson color and the flow is continuous 
and equable, with less force than from an artery ; 
from the capillaries the blood flows with a more 
or less rapid oozing, but is not projected to any 
distance from the body. 

There may be profuse bleeding, as when it occurs 
into one of the cavities of the body, without exter¬ 
nal loss of blood; this constitutes internal or 
concealed hemorrhage. The constitutional effects 
of hemorrhage are the same in kind, though dif¬ 
fering in intensity, whether the bleeding proceeds 
from arteries or veins, and whether the hemorrhage 
be apparent or concealed. 

When hemorrhage is profuse the face becomes 


Hemorrhage. 


239 


pale, the pulse small and rapid, the patient feels 
languid, the respiration assumes a sighing char¬ 
acter, the senses of sight and hearing are per¬ 
verted, the temples throb, the skin becomes cold, 
and at last, rather suddenly, the patient faints; 
the heart’s action is then very feeble, and the blood 
coagulates about the wound, and thus stops the 
bleeding. When consciousness returns the in¬ 
creased action of the heart may force away the 
clot, and the blood flows afresh; and the patient 
if not attended to may die. 

When a large artery is cut the bleeding is so 
excessive as to cause almost instant death; but 
with arteries of small size, and veins, the flow of 
blood although at first rapid, soon ceases after 
exposure to the air, which contracts the orifice 
of the vessels, and coagulates the blood. 

When endeavoring to control hemorrhages of 
any kind the patient’s mind and body should be 
kept as quiet as possible, and the position of the 
body should be such that the flow of blood to 
the bleeding part will be impeded. The wound or 
injured part should be bathed with cold water, 
and the bleeding, if slight, may be stopped by the 
application of ice or pressure. Hemorrhage from 
parts not easily subjected to pressure may be con¬ 
trolled by applying some of the various styptics, 
as the solution of subsulphate of iron, tannic acid, 
alum, etc, 


240 


General Diseases. 


When hemorrhage is profuse, the blood coming 
out of an artery in jets at each beat of the heart, 
a surgeon should be immediately sent for to ligate 
the injured vessel. The ligature as now used is 
the best method of checking arterial hemorrhage. 
While awaiting the arrival of the surgeon, the 
hemorrhage may be temporarily controlled * by 
means of pressure. If the hemorrhage is from an 
artery in the arm or leg, a handkerchief may be 
tied around the limb between the wound and the 
heart; by running a stick beneath the knot and 
twisting it up the requisite pressure may be 
attained. The injured person should avoid the 
use of stimulants, as they tend to increase the 
bleeding. 

Bleeding from the nose, or epistaxis, as it is 
called, is most frequent during childhood and 
early adolescence. It is seldom alarming in youth, 
unless it comes on during the progress of some 
disease; but in advanced life, bleeding at the nose 
gives rise to much anxiety. It may result from 
mechanical injury, congestion of the lining mem¬ 
brane of the nose, congestion of the brain, typhoid 
fever, hemorrhagic diathesis, or suppressed menstru 
ation. Care must be taken to discriminate between 
those cases where interference is necessary and 
where it is not. Should it be necessary to 
arrest the bleeding, a simple remedy is to place 
a small roll of paper or muslin above the front 


Hemorrhage. 


241 


teeth under the upper lip, and by pressing hard 
upon it, the passage of blood through the arteries 
leading to the nose will be checked, and the 
bleeding arrested. The patient should sit upright 
in a cool apartment, and benefit is often derived 
by holding one or both arms above the head for 
a short time. Should these remedies fail, a 
towel wet with ice-water may be applied to the 
neck and back, which often by reflex action will 
check the discharge ; or ice can be applied 
directly to the nose and forehead. External 
compression of the nostril with the fingers some¬ 
times succeeds by favoring the formation of a 
clot. In urgent cases the nostrils may be swabbed 
with the solution of subsulphate of iron or other 
styptics. 

Hemorrhages from the lungs, bowels, etc., will 
be referred to in connection with the diseases 
with which they are associated. 

Scrofula. The word scrofula is used to desig¬ 
nate a blood disease which may result either in 
the formation of tubercle or in some specific form 
of inflammation or ulceration. Scrofula with tuber¬ 
cle and scrofula without tubercle, are the two 
varieties of the disease. At the root of these 
varieties of one widely prevalent disease is a con¬ 
dition of system spoken of as the scrofulous 
strumous or tuberculous diathesis. 

The causes of scrofula are hereditary influence, 


242 


General Diseases. 


syphilis, debauchery, bad air, improper food, and 
a cold, damp atmosphere. 

“So slowly is scrofula developed,” says Professor 
Dickson, “that I do not believe that it is ever 
developed in one generation ; I believe that prepa¬ 
ration is made in one generation, and the develop¬ 
ment is completed in another; the fathers eat the 
sour grapes and the teeth of their children are 
set on edge.” 

Scrofula with tubercle more frequently affects 
the lungs than any other internal part. Numer¬ 
ous small tubercles form in these organs, and 
remain in a latent state during a longer or shorter 
period, gradually increasing in size, and at last 
soften, and cause incurable consumption. Con¬ 
sumption, however, is not necessarily connected 
with the formation of tubercle. The consolidation 
and softening of the lungs are often tubercular, 
yet may also be the result of some form of 
inflammation and condensation, as chronic pneu¬ 
monia, etc., of the pulmonary structure. 

Scrofula without tubercle or external scrofula 
manifests itself chiefly by glandular swellings, 
more or less extensive, ulcerations and indolent 
abscesses. One of the most frequent results of 
this variety of scrofula is inflammation of the 
lymphatic glands, especially those about the neck 
and lower jaw. Children are afflicted with this 
manifestation of scrofula more frequently than 


Scrofula. 


243 


adults. Scrofulous children are also frequently 
afflicted with sore eyes which require careful 
attention. 

In scrofulous ulcers extensive tracts of skin 
may be destroyed: and the efforts at repair are 
always slow and imperfect. Strumous abscesses 
often commence insidiously, and are apt to become 
indolent or suppurate imperfectly or burrow 
deeply in all directions. 

The only hope of cure a scrofulous subject has, 
lies in constitutional treatment; without which, 
the general health gradually deteriorates. The 
faulty nutrition must be improved, so as to promote 
the formation of healthy blood. If tubercle has 
formed we must endeavor to favor its absorption 
and to prevent its formation in the future. The 
patient should have a plain but generous and 
nourishing diet, plenty of sleep and exercise in 
the open air, and should not be allowed to breathe 
air that is in the slightest degree impure. Clean¬ 
liness should be given important consideration; 
bathing the entire body in water of a suitable 
temperature three or four times a week is advis¬ 
able, as it will maintain the functions of the skin 
and improve the general health. Sea bathing and 
sea air are especially beneficial. Flannels should 
be worn next to the skin throughout the year, 
and the clothing should be such as will protect 
the body from changes in temperature. Excesses 


244 


General Diseases . 


of all kinds and everything that tends to weaken 
the body and debilitate the system, should be 
avoided; and the patient should lead a life of 
moderation and temperance. 

In addition to an observance of these general 
suggestions, medicines, as a rule, are essential. 
Iodine -in different forms is often prescribed, but 
no one prescription can apply to all. Each case 
must be considered by itself, and such remedies 
both internal and external, should be given as the 
system demands and are best adapted to supply 
its wants. 

To prevent the transmission of scrofula is of 
the utmost importance. Doctor Tanner (not the 
faster, but an eminent English author) in speak¬ 
ing of scrofula with tubercle says : “ Remember¬ 
ing what has been said upon the hereditary 
nature of tuberculosis it should be noticed that 
there are three points to be particularly attended 
to in order to prevent its transmission. These 
are: i. To obtain well assorted marriages — 
the marriages of parties in sound health and 
vigor, and not related by blood to each other. 
2. Where this disease exists in the parents, or 
in either of them, great care must be taken to 
maintain the health of the mother during the 
period of utero-gestation. She should wear warm 
•clothing, take regular exercise in the open air, 
avoid heated rooms and late hours, sleep in a 


Scrofula. 


245 


large room, and have a plain and nourishing diet. 
3. On the birth of the child, every means ought 
to be taken to strengthen its general health, and 
to counteract the hereditary influence by atten¬ 
tion to the food, air, clothing, etc. If the mother 
be free from the strumous habit, she may suckle 
her offspring, but otherwise a young and healthy 
nurse should do so. At the age of nine or ten 
months the infant ought to be weaned and fed 
on cow’s or goat’s milk, a small quantity of 
light nutritious vegetables, and a little good broth. 
Doctor Paris strongly recommended milk impreg¬ 
nated with the fat of mutton suet, which he 
ordered to be prepared by inclosing the suet in a 
muslin bag, and then simmering it with the milk. 
The child must be clothed in flannel ; should live 
in apartments which are well ventilated and 
well lighted ; ought to have plenty of exercise in 
the open air; and once daily should have a cold 
sea-water bath, or a tepid bath with bay salt dis¬ 
solved in it. Ill-arranged, badly drained, close¬ 
smelling, damp houses must be avoided, as well 
as all those localities which are generally regarded 
as unhealthy.” 

Caries of the Spine. Caries is an unhealthy 
ulceration of bone, accompanied with a low form 
of inflammation. Caries of the spine is often 
met with in scrofulous children between ten and 
fifteen years of age. It commences with mflamma- 


246 


General Diseases. 


tion, usually attended with dull aching pain and 
weakness in the diseased part. Generally the 
bodies of several vertebrae are simultaneously 
affected; they become softened and disintegrated, 
and lead to disorganization of the intervertebral 
fibro -cartilages. 

The curvature of the spine and consequent 
deformity which is characteristic of the fully 
developed affection is caused by a crumbling or 
breaking down of the affected bones under the 
superincumbent weight of the head and upper 
part of the body. An abscess forms, which, if 

not arrested, makes its way to the surface fre¬ 
quently some distance from the seat of the dis¬ 

ease, and discharges a fluid often containing par¬ 
ticles of bone. 

Caries of the spine can be prevented by obe¬ 
dience to the laws of health. In its treatment, 
rest of the part and attention to the general 

health is of the utmost importance. The wear¬ 
ing of a supporting apparatus that will perma¬ 
nently remove all weight from the inflamed bones, 
counter irritation along the spine, nutritious food 
and the use of cod liver oil, iodide of iron, and 
the phosphates, frequently result in complete 
cures. 

Coxalgia or Hip Disease. Coxalgia or hip disease 
is a dreaded malady that is met with in persons under 
fifteen years of age, and occasionally in those who are 


Coxalgia or Hip Disease. 247 

older. More boys are affected with it than girls. 
Some surgeons regard it as a disease like spinal caries 
— that is, a constitutional affection depending upon a 
scrofulous diathesis; others look upon it as having a 
local origin and specially demanding local treatment. 
Probably both views are correct; the disease may be 
due to either local or constitutional causes. Its 
exciting causes are in most cases of an apparently 
trivial character, as slight blows, falls, sprains, over¬ 
exertion in walking, or sitting on cold stones or in 
damp places. 

Hip disease usually commences insidiously. There 
is eversion of the foot with apparent elongation of 
the leg; slight pain in the knee which is usually bent, 
and the child walks with a limping or shuffling gait, 
treading only on the toes of the affected limb. The 
obscure pains at first are often considered rheumatic, 
but examining the hip joint, it is found that pressing 
the head of the thigh bone into it gives pain. As the 
disease advances, the foot usually becomes inverted, 
the leg shortened, and the thigh partially flexed. 
Anchylosis may then occur in the hip and a cure 
effected, or a carious condition set in with destruc¬ 
tion of the acetabulum, formation of abscesses and 
death following. It is important that the treatment 
should begin early in this disease, and it requires 
time, patience and skill. It consists of perfect 
rest, the use of mechanical appliances, and such 
remedies as the condition of the patient may demand. 


248 


General Diseases . 


Rickets , or Rachitis. Rickets or rachitis is a con¬ 
stitutional disease occurring almost exclusively in 
childhood. It is characterized by softening of the 
bones and consequent alteration from their natural 
shape. The weight of the body bends the un¬ 
naturally soft bones of the legs, and the child 
thus becomes “bow legged.” The bones of the 
skull instead of becoming united, separate from 
each other, and the head becomes enlarged. The 
teeth are slow in appearing, and decay prema¬ 
turely. The abdomen is prominent, the body lean, 
and there is indigestion and general debility. 

The tendency to rickets may be inherited, but 
the disease is usually acquired. It often results 
from mal-nutrition, caused by insufficient and espe¬ 
cially improper food ; or from other sources of con¬ 
stitutional depression, as a residence in damp, dark, 
cold, or filthy dwellings; the respiration of foul, 
impure air, etc. 

Children may be predisposed to rickets when 
their parents have married too early or too late 
in life, or have weakened themselves by sexual 
excesses. The children of parents whose consti¬ 
tutions have been impaired by drunkenness, by 
syphilis, by scrofula, or by unhealthy occupations, 
and the offspring of delicate anaemic mothers are 
also predisposed to this disease. Rickets itself is 
not hereditary, but the tendency to it is, and 
when exciting causes are brought into action, the 


Syphilis. 


249 


disease is more easily developed in children who 
are predisposed than in those who are not. 

The treatment of rickets consists chiefly of 
hygienic measures. Fresh air, proper food, suit¬ 
able clothing, exercise and cleanliness are of par¬ 
amount importance. Sea-water baths are bene¬ 
ficial; and a residence by the seashore or in the 
country is preferable to the city. Lime-water, cod 
liver oil, and various preparations of iron, lime, 
and soda, have their value as remedies when prop¬ 
erly administered. 

To prevent the occurrence of rickets in delicate 
children, or in those who have inherited a ten¬ 
dency to the disease, the treatment must commence 
at birth. The infant should be fed only at the 
breast during the first eight months of life; if 
the mother is weak and sickly, a strong and 
healthy wet nurse must be procured. As the infant 
grows older its diet must be governed by its age. 

Syphilis. Syphilis, a venereal disease, may be 
inherited or acquired. Acquired syphilis can only 
arise from contagion; from the introduction of a 
peculiar animal poison into the system. It yields a 
specific pus which by contact with an abraded or 
tender surface is capable of extending the affection. 
Probably no poison has a more powerful yet insidious 
influence in deteriorating the constitution than the 
syphilitic. 

The phenomena of acquired syphilis has been 


General Diseases. 


250 

divided into the primary, secondary and tertiary 
stages. The primary symptoms are due to the 
application of the poison, or to inocculation. They 
consist of a specific sore called a chancre, followed 
by an inflammatory swelling of a lymphatic gland, 
usually in the groin, called a bubo. There are two 
kinds of specific sores, or chancres — soft and hard 
— and a period of incubation, varying from one 
to seven weeks, intervenes between exposure to 
contagion and the appearance of the chancre. 
The soft chancre is superficial, and is more com¬ 
mon than the hard chancre; the latter differs 
from it in possessing an indurated base, and in 
being elevated above the skin. The soft chancre, 
or chancroid, as it is termed, may form a bubo, 
but it is claimed that it has no power of con¬ 
taminating the system, while the hard or true 
chancre seldom forms a bubo, but yields to the 
system the syphilitic virus. It is usually several 
weeks after the appearance of the primary symp¬ 
toms of syphilis before the secondary symptoms 
present themselves. They are peculiar copper col¬ 
ored eruptions on the body, sore throat, mucous 
patches, enlargement of lymphatic glands, and 
slight loss of hair. After the subsidence of these 
symptoms, there is usually an interval of indefinite 
length before the development of the tertiary 
symptoms, which may affect almost any tissue or* 
organ of the body The skin, mucous membranes, 


Syphilis. 


251 


eyes, solid viscera, nervous system, areolar tissue, 
muscular and fibrous tissue and bones and peri¬ 
osteum present appearances of the destructive work 
of the loathsome disease. 

The treatment of syphilis is local and consti¬ 
tutional. The local treatment consists in promptly 
cauterizing the chancre and thus destroying the 
virus before it passes into the blood and contam¬ 
inates the system. Nitric acid is the caustic pre¬ 
ferred; it is one of the most effectual. One or 
two drops of it may be applied to the chancre 

from the point of a small sliver of wood. After 

% 

the application the part should be washed with 
castile soap and water and dressed with a sim¬ 
ple ointment and it will soon heal. A bubo may 
be treated in its early stages by the application 
of tincture of iodide and compression, but when 
it is far advanced its treatment depends upon its 
condition. 

When syphilis has contaminated the system, 
constitutional remedies should be employed, but 
care must be taken in their selection and admin¬ 
istration. Carelessness or neglect in treating this 
disease has often resulted in a life of suffering 
and remorse. The patient should consult at once 
a skilful and conscientious physician, for the 
condition of each case must be taken into con¬ 
sideration before the remedies best adapted to 
effect a cure can be prescribed. 


252 


General Diseases. 


Rheumatism. Rheumatism is one of the most 
common, painful, and annoying diseases with 
which Americans are afflicted. It appears under 
two distinct forms, the acute and chronic. Acute 
articular rheumatism, as the name implies, involves 
an affection of the articulations or joints. It is 
characterized by fever, profuse acid sweats, and 
inflammation of the fibrous tissues, surrounding 
one or more of the joints. The local phenomena 
are pain, tenderness, increased heat, swelling, and 
redness of the skin. 

Acute articular rheumatism, in most cases, 
commences with a sudden attack, which is usually 
occasioned by exposing the body to cold or 
dampness immediately after having been heated 
or fatigued. Cold and dampness, however, act 
only as exciting causes, and will not alone pro¬ 
duce rheumatism; a special predisposition, or a 
rheumatic diathesis, as it is termed, which may 
be inherited or acquired, is necessary to its devel¬ 
opment. A poison circulating in the blood con¬ 
stitutes the predisposition, and cold and damp¬ 
ness by checking the elimination through the 
skin and other emunctories of the poisonous prin¬ 
ciple as it forms, and by thus accumulating it 
in the blood, causes the disease. 

The earliest symptoms of acute rheumatism are 
chilliness and shivering, followed by restlessness, 
fever, and at the end of twenty-four or thirty- 


Rheumatism. 


253 


six hours, by stiffness, with aching pain in the 
limbs or joints. The pain quickly increases, 
soon accompanied by swelling, which is most 
apparent in joints not covered with muscles, as 
the knee, wrist, elbow, ankle, and the smaller 
joints of the hands and feet. Pain is especially 
excited by pressure over the joints, or move¬ 
ment of the affected part, and in severe cases, 
the slightest motion is attended with suffering of 
the most agonizing character. The pain is not 
so intense when the affected parts are perfectly 
quiet, and the sufferer is obliged to maintain as 
long as possible a fixed position. 

The patient is a pitiable object of helpless 
suffering. He is very restless, with a pulse full 
and bounding, face flushed, hot and moist, the 
body usually bathed in perspiration of a disagree¬ 
able sour odor, thirst intense, bowels constipated, 
urine scanty and high colored; but the disease 
seldom if ever ends fatally, except when it 
attacks some vital organ, as the heart. 

Rheumatism has a tendency to move from one 
part to another; it may suddenly leave one 
joint and appear in another, and then perhaps 
in a third, or it may return to its original seat. 
The most serious change is in severe cases, 
when it may attack the membranes of the heart. 
An attack of acute rheumatism under various modes 
of treatment has averaged about three weeks. 


254 


General Diseases. 


Chronic rheumatism may be the sequel of 

acute rheumatism, but it more frequently comes 

on gradually, independent of an acute attack. It 

is common among old people in the decline of 

life. In whatever part of the body fibrous tissues 

are found, there may be rheumatism. When it 

complicates, or follows a venereal disease, it is 
* 

called venereal rheumatism. In chronic rheuma¬ 
tism there may be only slight constitutional dis¬ 
turbance at first, but the sufferer is constantly 
annoyed, and after a while his existence is made 
miserable by wearying pains which destroy his 
comfort during the day, and cause him to be 
restless at night. 

A disordered state of the digestive organs 
sometimes brings on paroxysms of the disease 
known as rheumatism. 

In rheumatism of an erratic kind, dependent on 
exposure to cold, dampness, etc., warmth affords 
great relief; but in rheumatism due to a derange¬ 
ment of the digestive organs and secretions, and 
in venereal rheumatism when the blood is circu¬ 
lating a poisonous material through the system, 
the pains are aggravated by warmth. Rheuma¬ 
tism occasionally cripples some of the smaller 
joints, especially those of the fingers ; the knuckles 
become knobby, and the form and position of the 
fingers distorted. 

The treatment of rheumatism requires time, 


Rheumatism. 255 

patience, common sense, and skill. The cure of 
the chronic form of the disease is tedious and 
often very difficult. Probably there is no other 
disease for which so many different remedies have 
been used, or in which there has been such 
variations in the mode of treatment. Success in 
the treatment of either the acute or chronic form 
of the disease is dependent upon keeping the 
secreting organs in a state of healthy activity, 
and in protecting the patient from the vicissi¬ 
tudes of the weather. The medicines used must 
vary with many circumstances. 

In the treatment of acute articular rheumatism 
during the past few years, salicylic acid and its 
compounds have been used quite extensively; 
they probably have no anti-rheumatic virtues but 
relieve the disease merely by repressing two of 
its symptoms very much as quinnia and aconite, 
and veratrum and opium may do. The bicar¬ 
bonate of sodium probably approaches nearer the 
character of a true remedy. The National Dis¬ 
pensatory speaks of it as follows : “ In acute 

articular rheumatism, and notably in those cases 
of it in which many joints are involved, and in 
which there is high fever, acid sweats, and loaded 
urine, the bicarbonate of sodium is of inestimable 
benefit, provided that it be given so as to main¬ 
tain a neutral condition of the urine. Its efficacy 
is increased when the affected joints are swathed 


2 5 6 General Diseases. 

in compresses saturated with a solution of the 
salt.” 

The abnormal condition of the blood and excre¬ 
tions in acute rheumatism may be corrected by 
the alkalies and their salts; the alkaline treat¬ 
ment, as it is called, being considered the best by 
most authorities. A refreshing saline drink, or 
lemonade, is beneficial during the early stages of 
the disease, especially when there is much thirst. 
Relief from pain is often obtained by wrapping 
the affected joints in cotton wool and oiled silk, 
by which a sort of local vapor bath is formed. 

Chronic rheumatism requires different treatment 
from that of the acute. There are several special 
remedies which give relief; the best remedy to 
use varies with each case. Iodide of potassium is 
valuable in many cases; if the secretions are 
£fcid, bicarbonate of potash may be combined with 
it. Warm bathing, vapor, hot air, or hot water 
baths, either plain or alkaline, or medicated with 
sulphur, are often of great service when the pains 
are severe. During the interval of the pains, tepid 
salt water baths may be employed with ^frequent 
friction with a coarse towel or flesh-brush. There 
are various anodyne applications that will give 
temporary relief from the pain. The officinal lini¬ 
ment of aconite, or ammonia, or camphor, may 
be used, together with such internal remedies as 
the condition of the patient may require. All 


Gout. 


257 


sufferers from rheumatism should wear flannel next 
to the skin, and those who can afford it, do well 
by removing from those localities where the atmos¬ 
phere is not conducive to their health, and taking 
up their residence in a more congenial climate. 

Gout. Gout is a disease that may be defined 
as a specific inflammation, having a constitutional 
origin, and favored by an hereditary taint. Its 
exciting causes are indolent habits, the intemper¬ 
ate use of wine, and over-indulgence in the 
pleasures of the table; everything, in fact, which, 
by inducing mal-assimilation of the food, leads to 
the formation of an excess of uric acid in the 
blood is an important cause. 

Excess of food, by supplying excess of nitro¬ 
genous materials for the blood, tends ultimately 
to produce excess of urea and uric acid which 
have to be expelled by the kidneys. These or¬ 
gans perform their function properly for a while, 
but the excessive work thrown upon them ulti¬ 
mately causes them to act imperfectly, and there 
is consequent retention of certain materials in the 
blood which produces gout. 

An acute attack of gout may be preceded by 
premonitory symptoms, or it will come on suddenly. 
The spring is the season in which the disease is 
most apt to occur, while the autumn ranks next; 
probably owing to the variableness of the weather 
at these times. An individual is usually between 


258 


General Diseases. 


thirty and forty years of age when the first attack 
is experienced, and although the disease may come 
on without warning, it is frequently preceded two 
or three days by a disordered state of the digestive 
system. 

The first paroxysm generally declares itself about 
two or three o’clock in the morning, with a 
burning and throbbing pain in the ball of the 
great toe, or in the heel, or the fascia covering 
the instep of the foot, or the thumb. The chief 
seat of the disease, however, is usually in the 
first joint of the great toe. The affected part 
becomes red, swollen, and exquisitely tender to 
the slightest touch; the pain resembling that of 
a dislocated bone, and attended with the sensa¬ 
tion as if cold water was poured over the part. 
The sufferer may feel chilly and afterwards feverish, 
restless, very irritable and mentally depressed; 
his tongue is white and thickly furred, bowels 
constipated, and urine scanty, acid, and high col¬ 
ored. The pain although most excruciating, usually 
abates towards dawn, and the patient may fall 
asleep. 

On the second night the pain again becomes 
aggravated, and perhaps also on the third. What 
is known as “a fit of the gout,” usually passes off 
in a few days, but it may extend over a period of 
several weeks, after which the person feels much bet¬ 
ter both in mind and body than before the attack. 


Gout. 


259 


With improved strength and spirits the victim 
forgets that the disease will return, and pays but 
little or no attention to hygienic laws. Perhaps a 
happy interval of one, two, or three years may 
elapse before the second attack, but with each par¬ 
oxysm the interval is shortened and the disease 
becomes more severe and the attack of longer 
. duration, until at length the attacks are almost 
constant; the disease has then become chronic. 

An attack of gout confines itself to a single 
joint at the commencement, but as the disease 
progresses, several joints in both feet or in the 
hands suffer, and the constitutional derangement 
becomes more marked and constant. Deposits of 
a material resembling moist chalk are formed 
around and outside the affected joints. 

Gout and rheumatism are frequently present 
together; they become mixed and produce a 
hybrid disease called rheumatic gout. Irregular 
or misplaced gout is that form of the disease 
which instead of attacking the joints causes an 
inflammatory affection of some of the internal 
parts. 

The most efficient way to cure gout is to pay 
strict attention to the diet, to avoid the use of 
alcoholic drinks, and to take plenty of active 
exercise in the open air. Starving the disease will 
not cure it ; care must be taken that the quantity 
and quality of the food consumed is such as will 


26 o 


General Diseases. 


supply the wants of the system and no more. The 
secreting organs must be kept in a state of healthy 
activity. Mild laxatives, diuretics and diaphoretics 
often afford great relief. 

Colchicum has long been regarded as a specific 
for the gouty paroxysm ; it should be given in 
small doses at regular intervals, either alone or 
with alkalies or iodide potassium. 

Dropsy. Dropsy may be defined as an accumula¬ 
tion of watery fluid in one or more shut cavities of 
the body, or in the areola tissues, or in both. It is 
a*i important symptom or sequence of other disorders, 
and is rarely a disease itself. It may be caused 
by obstruction to the circulation of venous blood, 
or by the arrest of excretion and absorption, or by 
an excess of water in the blood. Disease of the 
heart or of the liver brings on dropsy by venous 
obstruction ; disease of the kidneys or the action 
of cold and wet upon the skin may produce it by 
checking excretion ; and wasting diseases are lia¬ 
ble to it in their advanced stages, on account of 
the watery state of the blood. 

The capillaries which ramify every part of the 
body constantly pour out upon every surface, in 
a state of health, a watery fluid to moisten the 
parts and thereby facilitate motion and prevent 
injury from friction. This watery fluid is speed¬ 
ily taken up by another set of vessels called the 
absorbents, which carry it back to the genera] 


Dropsy . 


261 

circulation. When the two processes of exhala¬ 
tion and absorption are properly balanced, the sur¬ 
faces will merely be kept moist ; but when the 
balance from some cause or other is disturbed, as 
when exhalation takes place more rapidly from 
the surfaces of one of the shut sacs, or absorp¬ 
tion more slowly than in health; or when the 
power of absorption ceases while exhalation i§ 
going on, then, under either of these circum¬ 
stances, dropsy must result. 

When dropsies arise from defective absorption 
they are called chronic or passive dropsies ; when 
from excessive exhalation of serous fluid, active 
or acute. Those due to disease of the heart or 
kidneys, slowly producing some alteration in the 
blood, with obstruction to the circulation, are usually 
of the first kind; those caused by cold, by sud¬ 
den checking of the urine or perspiration, by the 
poison of scarlatina, etc., of the second. 

Dropsy is distinguished by particular names, 
according to the part in which it is met with ; 
thus : when in the head it is called hydrocepha¬ 
lus ; in the chest, hydrothorax; in the belly, ascitis, 
and in the areolar tissue generally throughout the 
body, anasarca. When the connective tissue of 
only one region becomes dropsical it is said to 
be oedematous. 

In the treatment of dropsy the first object is 
to get rid of the preternatural accumulation of 


262 


General Diseases. 


watery fluid; this may be accomplished by the 
use of diruetics, purgatives and diaphoretics, or 
by the mechanical removal of the fluid by tap¬ 
ping and acupuncture : at the same time it is 
necessary to maintain the general nutrition of 
the system. The second object is to prevent 
dropsy in the future, which will be referred to 
in speaking of the different disorders of which 
it is the consequence. 

Hydrophobia. Hydrophobia is a terrible disease 
that arises from a morbid poison introduced into 
the system by the bite of a mad dog, or other 
rabid animal. It is called hydrophobia from the 
great dread that those who suffer from it mani¬ 
fest at the sight of water; it gives rise to hor¬ 
rible suffering, and the genuine disease is almost 
universally fatal. 

After a person has been bitten and the poison 
received into the body, the wound heals in the 
ordinary way, but the poison slowly affects certain 
changes in the system, increases in quantity and 
virulence, and at an indefinite period, exceeding 
thirty days, symptoms of the disease begin to 
manifest themselves. All persons bitten by a mad 
dog or other rabid animal are not attacked by 
hydrophobia, which is accounted for by the fact 
that the saliva is often wiped from the teeth of 
the animal as they pass through the clothes. It 
has been thought by some that hydrophobia is some- 


Hydrophobia. 


263 


times due to the mental anxiety that a person 
undergoes from the consciousness of his danger, but 
this is not true. Extreme anxiety may derange the 
nervous system, or cause an imaginary disease, but 
it can no more produce hydrophobia than it can 
small-pox, scarlet fever or syphilis. If a farmer 
wishes to raise a crop of corn, the seed must be 
planted ; no other seed but corn will produce corn ; 
so with hydrophobia. If the particular poison neces¬ 
sary to produce the disease has been introduced into 
the system, the disease will result; otherwise it 
cannot be produced. 

Unfortunately, when a person has been bitten by 
a rabid animal he has no means of knowing whether 
the poison necessary to produce disease has been 
introduced into his system or not, and he naturally 
worries. Even though his system be free from 
the poison, he has no positive evidence of it, and 
through mere anxiety alone, serious sickness and 
death may result. 

The precursory symptoms of genuine hydropho¬ 
bia are mental uneasiness, chilliness, languor, las¬ 
situde, restlessness, loss of appetite, and more or 
less headache, with usually a painful, red, and 
swollen condition of the part previously bitten. 
These symptoms may last one, two, or three days, 
when the confirmed, or hydrophobic stage of the 
disease commences with irritability, garrulity, pecu¬ 
liar rapid movements of the eyes, frequent sigh- 


264 


General Diseases . 


ing, nausea and fever ; the sufferer soon experiences 
pain and stiffness about the neck and throat, with 
difficulty of breathing and swallowing, a horror 
of liquids, a frightful sense of suffocation and 
terrible anxiety. The thirst is intense, yet the 
sufferer dare not or cannot drink, for every attempt 
to swallow fluids brings on distressing paroxysms 
of choking and sobbing ; and even any sudden 
impression, as of sound, a flash of light or a cur¬ 
rent of air passing over the face, brings on spas¬ 
modic gasping. The symptoms rapidly increase 
in severity until the nervous irritability ends in 
violent delirum, with exhaustion, or coma and 
death. It is usually two or three days from the 
commencement of the confirmed stage before death 
takes place, but it may not occur until the sixth. 

The treatment of hydrophobia must be directed 
to its prevention, for after the disease has become 
fully developed it is difficult and almost impos¬ 
sible to cure. The only sure way to prevent it 

is, immediately after being bit to cut out every 

part of the flesh which the animal’s teeth may 
have touched. This, though harsh treatment, is 

effectual. While awaiting it, forcible suction will 
aid in removing the poison, and ligature with any 
kind of a bandage above the part will retard the 
absorption of it. After excision the wound should be 
thoroughly washed by a stream of tepid water poured 
over it; lunar caustic may also be applied. To 


Caneer. 


26 5 


aid the elimination of any poison which may have 
absorbed before the use of the knife, a course of 
Turkish baths may be taken. When excision can¬ 
not be safely performed, free application of lunar 
caustic, or of a red hot iron is the next best thing. 
Excision and cauterization will lessen the danger 
of the horrible disease, even when it cannot be 
performed until the next day. In treating the 
disease itself, hypodermic injections of atropia 
or morphia, hot air baths, or the inhalation of an¬ 
aesthetics, often afford great relief. 

Cancer. A cancer, commonly called a malignant 
tumor, but professionally called carcinoma, is a 
local manifestation of a specific disease of the 
blood. It may attack almost any part of the body, 
but the organs most frequently attacked are the 
breasts in females, and the lower lip in males. It 
is not half as fatal in the latter as in the former. 

There are two principal varieties of the disease; 
viz. : scirrhus, or hard cancer, and medullary, or 
soft cancer. There are several sub-varieties of 
which it is unnecessary to speak. 

A cancer has a tendency to infiltrate neigh¬ 
boring tissues, to affect lymphatic glands, to 
soften and ulcerate, to recur after removal and 
to be followed by secondary deposits. 

The disease seldom occurs under twenty-five 
years of age, and a peculiarity of it is that the 
younger the person when attacked the more 


266 


General Diseases. 


rapid its progress; in early youth the tendency 
of a cancer is to increase constantly and rapidly 
until life is destroyed, while in advanced age it 

may remain in a state of torpidity for years. 

Cancer causes death either by hemorrhage or 
by mechanical interference with vital organs, or 
by general infection of the blood. Those afflicted 
with it should be placed in the best possible 
hygienic conditions, so that their constitutional 
powers may be kept up to as near the stand¬ 

ard of health as the disease will allow. Tonics, 
nourishing food, pure air, warm clothing, cleanli¬ 
ness and cheerful mental occupation are important. 
The pain, if excessive, may be prevented or re¬ 

lieved by the judicious use of anodynes. The 
prognosis of cancer especially when not properly 
cared for is unfavorable, and as its course in its 

fatal career is frequently rapid, those afflicted with 
the disease should seek medical advice early. 


IV.—FEVERS. 


Fevers are caused by the action of a poison on 
the blood, and through this on every tissue of 
the body; they thus affect the entire system. 
Their development usually is attended by a chill 
or chilliness, and they are characterized by an 
accelerated pulse, increased heat of the whole 
body, dryness of the skin, mouth hot and dry, 
preternatural thirst, scantiness of urine, impaired 
functions, muscular debility, diminished appetite 
and strength, frontal headache, pain in the loins 
and limbs, restlessness, disturbed sleep, and often 
nausea and vomiting. 

Fevers usually increase in violence in the 
evening; and they may be divided into five classes ; 
viz.: continued fevers, intermittent fever or ague, 
remittent fever, yellow fever, and eruptive fevers. 

Fevers are called continued when they pursue 
their course without any well-marked remissions. 
This class includes five varieties ; viz. : simple con¬ 
tinued fever, typhus fever, typhoid fever, cerebro¬ 
spinal fever and relapsing fever. 

Simple Continued Fever. Simple continued fever, 

when uncomplicated, is a mild disease, seldom 

267 


268 


Fevers. 


attended with any danger; it has a variable 
duration of from one to ten days. It usually 
commences without warning; the patient being 
suddenly seized with lassitude, disinclination for 
bodily or mental exertion, loss of appetite, and 
frontal headache. Irregular, chilly sensations may 
accompany the attack, the skin becomes hot and 
dry, bowels constipated, and urine scanty and high 
‘ colored. These symptoms may continue a few 

days, when the disease usually terminates in pro¬ 
fuse perspiration, leaving the patient languid and 
exhausted. Convalescence usually is rapid. Hygienic 
and palliative measures only, are called for in the 
treatment of this disease, in cold or temperate 
climates. The remedies indicated are a saline 
laxative, refrigerants, and perhaps anodynes. 

Typhus Fever. The prevalence of typhus fever 
in this country is comparatively limited, although 
the disease has been known from the earliest 
antiquity. A predisposition to it may be engen¬ 
dered by all those influences that depress the mind 
and body; but its exciting cause is the effluvia 
from human bodies accumulated in filthy towns, 
unventilated and crowded houses, ships, jails and 
camps. It is contagious and infectious, and often 
prevails epidemically. Intemperance, improper or 
insufficient food, great fatigue and excessive mental 
anxiety, prevent the system from resisting the 
contagion. 


Typhus Fever . 


269 


After the fever poison has been received into 
the system, there is usually a period of incubation, 
during which slight chilliness, nausea, loss of appe¬ 
tite, thirst, headache, pain in the back and weak¬ 
ness occur. The duration of this precursory stage 
varies, but it is usually only a few days, after 
which a cold stage of variable distinctness begins 
the attack. Fever quickly follows, with severe 
headache, whitish or yellowish tongue, and great 
irritability and restlessness towards evening. The 
patient is rather wakeful at night, but lies in a 
stupid condition during the day, occasionally mut¬ 
tering to himself. He is easily aroused, but soon 
falls into a half sleep again. The senses of taste, 
smell and hearing, are impaired in most cases, and 
the face assumes a dusky flush of redness. As the 
disease progresses, the pulse becomes more frequent, 
weaker and compressible, and the tongue grows 
darker, becoming brown, sometimes black, and 
often cracked or fissured. Costiveness, with scanty 
urine, is the general rule. From the fourth to 
the seventh days from the commencement of the 
fever, the mulberry typhus rash appears on the 
abdomen, chest, and upper part of the limbs. It 
consists of irregular spots of a dusky or mul¬ 
berry hue, disappearing on pressure, and feeling 
as if slightly raised above the skin^ their number 
and depth of color vary in proportion to the 
severity of the attack. 


270 


Fevers . 


During the second week the patient becomes 
much weaker, voice more feeble, and there is 
deficiency of sensation, and insensibility to impres¬ 
sions. Delirium usually occurs at the end of the 
first week, and sometimes, especially about the 9th 
10th, or nth day, there is profound somnolence, 
which may end in fatal coma. This is the critical 
period after which a decline of the disease may be 
looked for. 

The danger of the fever is increased when it 
is complicated by disease of the lungs ; among the 
unfavorable symptoms are extreme prostration, 
hiccough, a brown, hard, tremulous tongue, muscular 
tremor, abundant eruption and persistent sleepless¬ 
ness with delirium. The duration of an attack is 
usually about three weeks; but when the disease 
proves fatal, death usually occurs between the 12th 
and 20th day. 

The lower classes of society are afflicted with 
typhus fever more frequently than the upper, as 
may be inferred from the nature of its origin. 
To prevent the generation of the typhus poison, 
wholesome food, an abundance of pure air, and an 
observance of the laws of health are essential. 

The most important part of the treatment of 
the disease consists of hygienic and supporting 
measures. Perfect quiet, careful nursing, plenty of 
fresh air, attention to the diet, cleanliness and 
the use of disinfectants are of paramount import- 


Typhus Fever. 


271 


ance. Concentrated liquid food — beef tea, chicken 
or mutton broth, raw eggs, milk, etc.,—and if the 
powers of life begin to fail, give such quantity of 
the best brandy or whiskey as may be required. 
Barley water acidulated with lemon juice may be 
used as a drink. Cooling applications may be made 
to the head when necessary, and the body may be 
cleansed by bathing with tepid water. A mild lax¬ 
ative should be given at the commencement of the 
disease, but as it progresses constipation usually is 
best relieved by an injection of warm soapsuds. 
To meet the difficulties of the case as they arise, 
and to guide the disease to a favorable termination, 
is the grand desideratum; and in addition to the 
general plan of treatment suggested, such medicines 
may be used as the condition of the patient may 
demand. 

Typhoid Fever. Typhoid fever resembles typhus 
in its main features, and until about the year 1840, 
they were generally regarded as merely two stages 
of the same affection; but they are essentially 
distinct diseases—as distinct as small-pox and 
measles. 

Typhoid fever is more gradual in its approach 
than any other fever, and usually in its early 
stages there is slight bleeding at the nose, and 
a bronchial cough, which symptoms do not occur 
in typhus. The countenance is purplish red in 
typhoid, and dusky red in typhus. Diarrhoea is 


2^2 


Fevers. 


almost always present m typhoid (often accompa¬ 
nied with hemorrhage), while constipation is the 
rule in typhus. The eruption in typhoid consists 
of rose-colored spots thinly scattered, and often 
entirely absent; they appear between the seventh 
and fourteenth day, and soon disappear ; while the 
mulberry rash of typhus comes out between the 
fourth and seventh day and lasts until the ter¬ 
mination of the disease, giving the skin a dusky 
and mottled appearance. In typhoid, the pulse 
and temperature rise and fall independently of 
each other, though both generally remain high to 
the fifteenth day ; while in typhus the pulse and 
temperature rise steadily (the pulse to about 120 
and temperature to 105 °) until about the third day, 
when they remain stationary for a few days, and 
then begin to fall about the ninth day. In typhoid 
the evening temperature is higher than the morn¬ 
ing ; in typhus it is the reverse. Typhoid rarely 
attacks persons after forty years of age, but typhus 
may occur at any age. Relapses occasionally occur 
in typhoid, but not in typhus. In typhoid the dura¬ 
tion of the symptoms is seldom less than twenty- 
two to thirty days ; in typhus it is from fourteen 
to twenty-one days. 

Typhoid fever is most prevalent in autumn; it 
is an endemic, slightly infectious disease generated 
by putrefying animal matter. Frequent sources of 
the disease are impure drinking-water, and the efflu- 


Typhoid Fever. 


273 


via from foul drains. After the poison has been 
received into the system, there is a period of incu¬ 
bation, which varies from ten to fourteen days; 
then the disease sets in slowly and insidiously. 

The patient experiences a sense of anxiety, 
with fatigue and aching about the body; in the 
course of a few days he has chills, headache, in¬ 
tolerance of light, loss of appetite, intense thirst, 
and his tongue becomes coated with a creamy 

fur, but red at the tip. The patient may now 

take to bed with fever of considerable violence, 
and his face acquires a dark purple flush. About 

the end of the first week swelling of the belly 

and diarrhoea come on ; watery passages are char¬ 
acteristic of this disease. The patient lies dozing, 
perhaps muttering, unless disturbed, all day; but 
is more or less wakeful and delirious at night. 

The increase in the temperature of the body 
from the normal degree (98.5°) is gradual during 
the first four or five days; reaching 104° on the 
evening of the latter. An attack of disease in 
which on the second day the heat in the axilla 
is as high as 104°, is not typhoid fever; neither 
is a disease typhoid fever in which the tempera¬ 
ture falls below 103° from the fourth to the 
eleventh day. There is a difference of one or two 
between the morning and evening temperature of 
the body in typhoid fever; the greatest heat 
being in the evening. 


274 


Fevers. 


The most unfavorable symptoms are persistent 
diarrhoea with hemorrhage, a very rapid pulse 
with great heat of skin, and continuous delirium 
with muscular twitchings. 

Typhoid fever requires very nearly the same 
treatment as that suggested for typhus. The 
diarrhoea need not be checked unless the passages 
number more than three or four a day, or are 
uncommonly copious; then astringents combined 
with opium may be administered. The discharges 
should be promptly removed and appropriate dis¬ 
infectants used. The patient requires to be care¬ 
fully attended to during convalescence, as relapses 
are apt to occur; and the return to a generous 
diet must be gradual. 

Cerebro-Spinal Fever. Cerebro-spinal fever is a 
malignant epidemic disease attended with lesions 
of the brain and spinal cord; chiefly of their 
surfaces and membranes. It prevails more exten¬ 
sively during cold weather than hot; attacks more 
males than females ; and more persons under four¬ 
teen than over that age. The attack is gener¬ 
ally sudden. Its symptoms are chilliness, terrible 
pain in the head, contraction of the muscles of 
the back of the neck, with intense pain, tender¬ 
ness of the spine and limbs, nausea, vomiting 
feverishness and violent delirium, ending sometimes 
in coma; when there is no coma there is painful 
sensitiveness of the surface of the body. Convul- 


Cerebro- Spinal Fever. 


275 


sions often occur in the young, and the terrible 
pains give rise to hideous cries. 

Cerebro-spinal fever is very fatal; more than 
half the cases die. Some epidemics have been 
more rapidly fatal than others; and the disease 
has destroyed life in less than six hours from its 
commencement. Those who survive five days have 
a fair, though not certain, prospect of recovery. 
Convalescence is tedious, and relapses are apt to 
occur. In favorable cases a period varying from 
two weeks to six months may elapse between the 
day of attack and that of complete recovery; all 
complications greatly aggravate the danger. 

The most unfavorable symptoms are a preternat- 
urally slow pulse; rigid retraction of the head;; 
convulsions; incontinence of urine; coldness of the 
skin with a diffused purplish hue; paralysis of the 
muscles of deglutition; dilatation and insensibility 
of the pupils, and deep coma. Recovery may occur 
after violent delirium, but when the patient has 
become profoundly comatose there is scarcely any 
hope. 

In the treatment of the disease stimulants should 
be avoided until demanded by the flagging circula¬ 
tion. Probably more satisfactory results are ob¬ 
tained by the judicious use of calabar bean, ergot, 
bromide potassium and morphia, than any other 
remedies ; these medicines to be used intelligently, 
as indicated by circumstances. Ice, or cold appli- 


Fevers. 


276 

cations to the head, nape of the neck, and spine, 
is valuable in some cases; or in others it may 
be advisable to place a small blister behind the 
ears, a mustard draft to the nape of the neck 
and feet, and iodine along the region of the spine. 
The regimen should be the same as in other 
severe fevers. During convalescence the exhausted 
system may require a course of tonics. 

Relapsing Fever. Relapsing fever prevails chiefly 
among the poorest classes in crowded localities ; 
as its special cause appears to be over-crowding 
and starvation, it has been called “famine fever.” 
It is not common in this country ; the chief suf¬ 
ferers from it have been in Ireland during seasons 
of famine and destitution. It may occur in all 
seasons of the year and attack both sexes, of all 
ages, alike. 

The attack is usually abrupt, and commences 
with rigors, frontal headache, muscular pains, and 
depression. As the disease advances, vomiting a 
bitter fluid, a white, moist tongue, hot, dry skin, 
epigastric tenderness, constipation, high-colored 
urine, a full, rapid pulse, and great restlessness are 
the symptoms presented. On the fifth, sixth, or 
seventh day, as matters begin to assume a threat¬ 
ening aspect, a profuse perspiration breaks out 
over the whole body, the fever disappears, and 
the patient is left greatly exhausted. He fancies 
perhaps that he is free from the disease, and that 


Intermittent Fever or Ague . 


277 


a course of tonics will restore his strength. His 
improvement, however, is of short duration, for 
about the seventh day from the critical sweating— 
fourteenth day from the commencement of the 
disease — there is an abrupt relapse with a repe¬ 
tition of all the symptoms ; but in three or four 
perspiration again sets in, and for a second time 
is followed by relief. Frequently a third relapse 
occurs. The debility is very great, and the re¬ 
turn to perfect health very slow, but the disease 
is seldom fatal. 

The treatment consists of a mild cathartic at 
the commencement of the disorder; refrigerating 
drinks, farinaceous diet, milk, and perfect rest, 
with opiates to relieve pain. The patient’s 
uneasy sensations may be soothed by bathing 
the body with tepid water. When there is great 
prostration, the moderate use of wine may be 
allowed. 

Intermittent Fever or Ague. Intermittent fever 
consists of cold, hot and sweating stages, in suc¬ 
cession, attending each paroxysm, and' followed 
by an intermission; no other disease has ordi¬ 
narily so regular a succession of definite symp¬ 
toms. There are several varieties of the disease; 
those commonly met with are called quotidian, 
tertian and quartan. When the paroxysm occurs 
at the same hour every day, it is called 
quotidian; when every other day, tertian; and 


278 


Fevers. 


when it is absent for two whole days and then 
recurs, quartan. The interval is twenty-four 
hours in the first species, forty-eight in the 
second, and seventy-two in the third. The 
octan, or weekly return of the attack, is also 
occasionally met with. The time between the 
commencement of one paroxysm, and the begin¬ 
ning of the next, is termed the interval; that 
between the termination of one paroxysm, and 
the commencement of the next, the intermission. 

The exciting cause of intermittent fever is 
marsh miasma, or the effluvia arising from stag¬ 
nant water or marshy ground. These emanations 
are invisible, and are known as malaria. 

Those most susceptible to the disease, are the 
young, unhealthy, over-fatigued, and such as are 
exhausted from want of food or sleep. Malarious 
districts are most dangerous at night. Those 
predisposed to intermittent fever, should not go 
outdoors between sunset and sunrise. As the 
poison lies near the ground, it is best for such 
persons to occupy rooms on the upper floor 
of the house. 

The form of the disease which arises from 
exposure to malaria varies according to the con¬ 
stitutional predisposition of the individual; that 
which will produce ague in one person, perhaps 
giving rise to remittent fever or dysentery in 
another. 


Intermittent Fever or Ague. 279 

An attack of intermittent fever or ague begins 
with languor, frequent yawning and stretching, 
sluggishness in motion, a sense of debility and 
loss of appetite. The face becomes pale, and the 
features shrink. A sensation of cold soon comes 
on, with pains in the head, back, loins and 
joints. There is often a feeling as if streams of 
cold water were running down the back with 
shivering, chattering of teeth, and rigors, or 
tremulous movements. Nausea and vomiting usu¬ 
ally occur; the respiration is hurried and oppressed; 
there is a peculiar mental irritability; often urgent 
thirst; and the pulse is small, frequent, and often 
irregular. The duration of this cold stage varies 
from ten minutes to two or three hours, and is 
gradually succeeded by the hot stage, which is 
one of reaction. The surface of the body becomes 
dry and intensely hot. The mouth is parched, 
tongue furred, there is excessive thirst, pulse 
full and bounding, sense of fulness in the head 
with violent headache, great restlessness, general 
uneasiness and sometimes delirium. This condition 
continues rarely less than two or more than 
twelve hours; then follows the sweating stage. 
This comes on gradually, commencing with the 
face, and extending over the whole body, and is 
attended with increased comfort. The pulse and 
breathing become more natural, and the headache, 
heat of skin, and thirst abate. 


28 o 


Fevers. 


If the case be recent, the patient may fancy, 
as all the distressing symptoms are relieved, that 
health is about restored ; but these pleasing 
thoughts vanish with the return of the next 
paroxysm. Occasionally one or two of the three 
stages of intermittent fever are absent ; then 
there is only a chill, or a fever, or a sweat 
occurring daily, or every other day. 

The first object in the treatment of intermittent 
fever is to remove from the malarious district; for 
the best remedies often prove ineffectual without 
a change of residence. During the paroxysms, pallia¬ 
tive measures are indicated. A full opiate, or the 
moderate use of stimulants at the beginning of the 
cold stage, is often beneficial ; warm, diluent 
drinks may be freely allowed; while the applica¬ 
tion of external warmth should be employed. 

During the hot stage, ice and cooling drinks 
are required, and the surface of the body may be 
sponged with tepid water. Tepid drinks may be 
given during the sweating stage, to encourage 
the action of the skin. 

What is wanted is something that will prevent 
the recurrence of the paroxysm; for the disease, 
if left to itself, may continue several weeks or 
months. Of the remedies used to arrest the 
disease, sulphate of quinine, in appropriate doses, 
has the most universal reliance; arsenic ranks 
next. There are various other remedies in use 


Intermittent Fever or Ague. 281 

which have their value, and may be administered 
when, for some reason or other, these are 
undesirable. 

Remitte 7 it Fever. The causes of remittent fever 
are the same as those of the disease just 
described. Its symptoms also resemble those of 
intermittent fever, but are distinguished from it 
by the occurrence of remissions instead of inter¬ 
missions ; there is no cessation of the fever, but 
simply an abatement or diminution. The period 
of remission varies from six to twelve or fourteen 
hours, at the end of which time the feverish 
excitement increases. 

The disease, if not shortened by proper treat¬ 
ment, will run on one, two, or three weeks, 
when it may terminate rather abruptly in pro¬ 
fuse perspiration, or its symptoms may merge 
into those of low fever. 

The principles of treatment of remittent fever 
are essentially the same as in intermittent fever, 
or in the continued fevers. To arrest the disease, 
anti-periodic remedies should be employed. 

Yellow Fever. Yellow fever is an acute malignant 
epidemic disease, met with only in warm climates ; 
frost destroys its specific poison. Its attack is sud~ 
den, often commencing in the middle of the night; 
but in some cases, for two or three days before 
the seizure, there is a feeling of weakness and 
restlessness, followed by loss of appetite, giddiness, 


282 


Fevers. 


frontal headache, chilliness, and pains in the back 
or limbs. These symptoms are succeeded by a 
high degree of fever, hot, dry skin, excessive 
thirst, flushings in the face, eyes congested and 
painful, gaspings for cool air, violent headache, 
irritability of the stomach with tenderness on 
pressure, nausea, vomiting, furred tongue, anxiety, 
great restlessness, heavy respiration, sighing, sleep¬ 
lessness, and perhaps active delirium. 

These symptoms greatly diminish in severity at 
the end of the second or third day, and the flush 
of the face and other portions of the skin is 
succeeded by yellowness, which grows deeper as 
the disease advances. In some cases, however, 
convalescence now takes place; but more fre¬ 
quently the disease becomes aggravated in the 
course of twenty-four or forty-eight hours, and 
prostration and collapse follow. 

As the fever progresses, the stomach becomes 
excessively irritable, and when the disease is 
about to end fatally, a black or dark-colored fluid 
is vomited. This “black vomit,” as it is termed, 
.consists of blood altered by the action of the 
fluids of the stomach. About one third of those 
afflicted with yellow fever die from its effects. 
Death most frequently occurs on the fourth, fifth, 
or sixth day. 

No specific has been found for yellow fever, 
and no abortive treatment. Attention should be 


Yellow Fever. 


283 


given the hygienic management of the case, and 
such medicines used as will relieve the distress¬ 
ing symptoms as they occur. 


V. — THE ERUPTIVE FEVERS. 


The eruptive fevers are continued fevers at¬ 
tended with eruptions or efflorescence. The 
chief are small-pox, cow-pox, chicken-pox, measles, 
and scarlet fever. They all arise from a specific 
contagious poison, and each is a distinct species 
of fever, having phenomena hnd laws which are 
distinctive. A variable amount of time (called the 
period of incubation) elapses between the recep¬ 
tion of the poison and the occurrence of the 
symptoms. 

Those who have been exposed to small-pox, 
scarlet fever, measles, typhus fever, diphtheria, 
whooping cough, or any other infectious disease, 
should not take up their residence in a household 
where there are others liable to be infected, until 
the expiration of the period of incubation shows 
that they have escaped. Typhus fever, diphtheria, 
and whooping cough, are not eruptive fevers, but 
as they are infectious, we speak of them in this 
connection. 

The period of incubation, without going to 
extremes, may, for practical purposes, be consid¬ 
ered to be for small-pox, typhus, whooping cough, 

284 


How to Prevent the Spread of Diseases. 285 


and measles, fourteen days each; and scarlet 
fever and diphtheria ten days each. Convalescence 
from these fevers should be considered as still 
liable to give off infection until the expiration of 
time — counting from the beginning of the illness 
— ranging for each fever as stated below: Small¬ 
pox, fourteen days after the termination of scab¬ 
bing ; typhus, twenty-eight days from inception; 
scarlet fever, seven weeks from inception; diph¬ 
theria, six weeks from inception; whooping-cough, 
eight weeks from inception ; measles, six weeks 
from inception. 

How to Prevent the Spread of Infectious Diseases. 
The Board of Health of the State of New York 
has published a memorandum (circular No. 15) 
of sanitary precautions to prevent the spreading 
of infectious diseases, which we present as follows : 

Cleajiliness and Ventilation are in all cases and everywhere of the 
first importance. The diseases which are spread chiefly from place to 
place and from person to person by means of their own infection or 
contagion, are to be regarded and treated as enemies, to be resisted 
and stamped out. The propagation of some of them with the help of 
local causes, seen or unseen, and the fatality, as well as spread, of 
each one of them, is increased by personal uncleanliness and local 
unhealthfulness. Diphtheria, Measles, Scarlet fever, Typhoid fever, 
Puerperal fever and Small-pox, are the most pestilent of these infec¬ 
tious diseases in this State. But Typhoid fever and Malignant Cholera 
are infectious by means of excremental matters rather than from bod¬ 
ily emanations. Typhus spreads by its personal contagion, and it orig¬ 
inates among crowded and uncleanly people. These diseases are all 
infectious and contagious and require disinfection and all sanitary pre¬ 
cautions that prevent infection. 

Small-Pox, Scarlet Fever , Diphtheria , or Measles. The patient 
should be kept in a separate room (preferably on an upper floor) from 


286 


The Eruptive Fevers. 


which, if possible, carpets, curtains, stuffed furniture, clothing and 
other articles not required for immediate use, should be removed 
beforehand; and no person except the physician, nurse or parent, 
should be allowed to enter the sick-room, or to touch any of the arti¬ 
cles used therein, until after thorough disinfection. 

To Disinfect Clothing , ore., in the. Sick-Room. Keep in the room a 
tub containing a quarter of a pound of sulphate of zinc and two ounces 
of common salt to each gallon of water. All bed linen, towels, cloth¬ 
ing, handkerchiefs, *etc., used about the patient, should be allowed to 
soak in this solution for at least an hour before removal from the 
room, and afterwards be thoroughly boiled, separate from the rest of 
the family washing. Never send such articles to a public laundry. 

To Disinfect Discharges from the Patient. Use the same disinfect¬ 
ing fluid as in disinfecting clothing, but three times stronger, or use 
copperas water, made by dissolving a pound and a half of copperas in 
a gallon of water. The latter answers'for all excremental discharges, 
while the former is best for all articles of clothing and furniture. All 
vessels used in the sick-room should be disinfected with one or other 
of these disinfecting fluids, unless immediately immersed in boiling 
water. Disinfect the discharges and clothing immediately. 

Typhoid Fever. The poison lies in the discharges from the bowels, 
which should be at once disinfected with the solution of the zinc-salt, 
or of copperas. Particular care should be exercised to prevent any 
possible contamination of sources of drinking water with these dis¬ 
charges. Bed clothing or other articles soiled by the evacuations 
should be treated with the zinc solution, and be boiled. 

Dysentery and Cholera. Same regulations as in Typhoid fever. 

Typhus Frver. Enforce free ventilation, and disinfection of clothing, 
as above described. Attend to the fumigation of the sick-room and its 
bedding. 

To Prevent the Body of the Patient from Spreading Contagion. In 
the eruptive diseases, especially in Scarlet fever, the patient’s body 
should be anointed at least twi ce a day with oil, lard, or vaseline, con¬ 
taining about ten grains of carbolic acid or of thymol to the ounce. 
This process should be maintained until all bran-like scaling of the 
skin is at an end. The zinc-salt solution should be used as directed. 
Before again associating with unprotected persons, the paiient should 
have several complete ablutions, including thorough washing of the 
hair with soap or borax; and none of the clothing worn for several 
days before the disease declared itself should be again used until 
thoroughly disinfected, and ventilated in the open air several days. 

Avoid visiting houses where there are any of these diseases. Occu¬ 
pants of such houses should not visit. 


Instructions for Disinfection. 


287 


Instructions for Disinfection. The best instruc¬ 
tions for disinfection that we can give is to 
present those prepared under the direction of 
the National Board of Health and published by 
the State Board of Health of New York as'cir¬ 
cular number sixteen. They are as follows : 

Disinfection is the destruction of the poisons of infectious and con¬ 
tagious diseases. 

Deodorizers , or substances which destroy smells, are not necessarily 
disinfectants, and disinfectants do not necessarily have an odor. 

Disinfection cannot compensate for want of cleanliness nor of ventil¬ 
ation. 

I. Disinfectants to be Employed. 

(1.) Roll sulphur (brimstone) for fumigation. 

(2.) Sulphate of iron (copperas) dissolved in water in the proportion 
of one and a half pounds to the gallon : for soil, sewers, etc. 

(3.) Sulphate of zinc and common salt, dissolved together in water 
in the proportions of four ounces sulphate and two ounces salt 
to the gallon : for clothing, bed linen, etc. 

II. How to use Disinfectants. 

(1.) In the Sick-rooni. The most available agents are fresh air and 
cleanliness. The clothing, towels, bed-linen, etc., should, on removal 
from the patient, and before they are taken from the room, be placed 
in a pail or tub of the zinc solution, boiling-hot if possible. 

All discharges should either be received in vessels containing cop¬ 
peras solution, or, when this is impracticable, should be immediately 
covered with copperas solution. All vessels used about the patient 
should be cleansed with the same solution. 

Unnecessary furniture, especially that which is stuffed, carpets and 
hangings, should, when possible, be removed from the room at the 
outset; otherwise, they should remain for subsequent fumigation and 
treatment. 

(2.) Fumigation with sulphur is the only practicable method for 
disinfecting the house. For this purpose, the rooms to be disinfected 
must be vacated. Heavy clothing, blankets, bedding, and other arti¬ 
cles which cannot be treated with zinc solution, should be opened and 
exposed during fumigation, as directed below. Close the rooms as 
tightly as possible, place the sulphur in iron pans supported upon 


288 


The Eruptive Fevers. 


bricks placed in wash-tubs containing a little water, set it on fire by 
hot coals or with the aid of a spoonful of alcohol, and allow the room 
to remain closed for twenty-four hours. For a room about ten feet 
square, at least two pounds of sulphur should be used ; for larger 
rooms, proportionally increased quantities. 

(3.) Premises. Cellars, yards, stables, gutters, privies, cesspools, 
water-closets, drains, sewers, etc., should be frequently and liberally 
treated with copperas solution. The copperas solution is easily pre¬ 
pared by hanging a basket containing about sixty pounds of copperas 
in a barrel of water. 

(4.) Body and Bed Clothing ; etc. It is best to burn all articles 
which have been in contact with persons sick with contagious or infec¬ 
tious diseases. Articles too valuable to be destroyed should be 
treated as follows : 

(a.) Cotton, linen, flannels, blankets, etc., should be treated with the 
boiling-hot zinc solution; introduce piece by piece, secure 
thorough wetting, and boil for at least half an hour. 

(b.) Heavy woolen clothing, silks, furs, stuffed bed-covers, beds, and 
other articles which cannot be treated with the zinc solution, 
should be hung in the room during fumigation, their surfaces 
thoroughly exposed, and pockets turned inside out. Afterward 
they should be hung in the open air, beaten and shaken. Pil¬ 
lows, beds, stuffed mattresses, upholstered furniture, etc., 
should be cut open, the contents spread out and thoroughly 
fumigated. Carpets are best fumigated on the floor, but should 
afterward be removed to the open air and thoroughly beaten. 

(5.) Corpses , especially of persons that have died of any infectious or 
malignant disease , should be thoroughly washed with a zinc solution of 
double strength; should then be wrapped in a sheet wet with the zinc 
solution, and buried at once. 

Metalic, metal-lined, or air-tight coffins should be used when possi¬ 
ble ; certainly when the body is to be transported for any considerable 
distance. 

Note.— These instructions were prepared at the request of the National Board of 
Health by Professors C. F. Chandler, Henry Draper, G. F. Barker, S. O Van- 
der-Poel, E. G. Janeway and Ira Remsen. They combine the best experience 
with accurate knowledge of the chemistry of Disinfection. 

The chemicals here recommended are simple, safe and effectual; they are cheap 
and can be obtained in every town, and used in the ways here described, they will 
destroy contagious and infectious matter, and the directions for Fumigation, Boiling, 
Ventilation, Cleansing and Drying can be carried out in any house; but let it be 
remembered that there are no substitutes for Cleanliness and Fresh A ir. 

The State Board of Health advises that these instructions be followed. 

Albany, March , 1882. ELISHA HARRIS, M. D., Secretary. 



Small-pox. 


289 


Small-pox. Small-pox is the most remarkable 
and most loathsome of the eruptive fevers. It 
is clue to the reception into the blood of a specific 
poison which does not give indications of its 
power until twelve days afterwards. 

Small-pox is supposed to have been introduced 
from Ethiopia into Arabia about A. d. 572. The 
wars which were carried on in the East, and par¬ 
ticularly the crusades in the twelfth and thirteenth 
centuries, introduced it into Europe; first into 
Spain and France, and then into other countries. 

The disease in its entire course goes through 
four stages : that of incubation, of primary fever, 
of eruption, and of secondary fever. After the 
period of incubation the attack begins with languor, 
shivering, pain in the back and loins, headache 

and loss of appetite, followed by heat and dry¬ 
ness of the skin, a hard and frequent pulse, pain 
in the epigastrium, with nausea, vomiting, and 
sometimes delirium or convulsions. On the third 
day an eruption of small red pimples appears, first 
on the face, then on the neck, arms, trunk, and 
lower limbs. The pimples gradually ripen into 
pustules, which on the eighth or ninth day gen¬ 
erally begin to break, and crusts or scabs form 

on them. Four or five days later (about the four¬ 

teenth day of the fever) the scabs begin to fall 
off, and desquamation is usually completed by 
the end of the third week of the attack. 


290 


The Eruptive Fevers. 


The severity of the disease bears a direct rela¬ 
tion to the quantity of the eruption. When the 
pustules are numerous they run together and form 
an irregular outline; when fewer they are dis¬ 
tinct or separate from each other. The former 
is called confluent small-pox, and is never free 
from danger; the latter discrete small-pox, and is 
seldom attended with danger. In confluent small¬ 
pox, not only is the whole surface of the body 
covered with inflamed pustules, but the mouth, 
throat, eyes and ears may be invaded, and blind¬ 
ness and deafness often follow. A peculiar disc - 
greeable odor emanates from the body of those 
afflicted with the disease, which once smelt can¬ 
not be forgotten. 

Varioloid, or abortive small-pox, is that form in 
which the eruption stops in its vesicular stage, 
most of the vesicles drying up instead of going 
on to the formation of pustules. This modifica¬ 
tion of the disease is due to vaccination. One 
attack of small-pox as a rule exhausts the suscept¬ 
ibility of the system to the future influence of 
the poison. 

Small-pox is a disease that is self-limited. There 
is no specific remedy for it, no cutting it short. 
All that can be done is to palliate it, make the 
patient as comfortable as circumstances will allow, 
and conduct the disease to a favorable termina¬ 
tion, 


Small-pox. 


291 


When the preliminary symptoms are presented 
the patient should take a warm mustard foot bath, 
then go to bed in a large, well-ventilated room, 
free from carpets, curtains, and superfluous fur¬ 
niture. Lemonade, barley-water, plain water, or 
ice may be allowed, and also ripe fruits, espe¬ 
cially grapes and oranges in moderate quanti¬ 
ties. If constipation accompanies the fever, a 
cooling laxative, as Rochelle salts or citrate mag¬ 
nesia, may be given ; then perhaps refrigerant 
diaphoretics will be required. Sponging the body 
with tepid water, if the skin is very hot, will 
prove very refreshing, especially if its use be 
followed by a change of linen. As there is a ten¬ 
dency to exhaustion, concentrated liquid nourish¬ 
ment should be given, accompanied, if necessary, 
by a moderate quantity of alcoholic stimulants. 
To relieve the intolerable itching, the officinal 
lime liniment may be freely used; it will also 
prevent pitting to a certain extent. It may be 
prepared by mixing one half pint lime water with 
seven troy ounces of flaxseed oil. 

It is often important to prevent pitting of the 
face. This may be accomplished by excluding 
the air and light, and lessening the irritation and 
keeping the tissues moist. A plan often adopted 
to prevent pitting is, to touch each pimple on 
the face, on the fourth or fifth day after the at¬ 
tack, with a point of lunar caustic; then apply 


292 


The Eruptive Fevers . 


a flaxseed poultice to the whole face for four or 
five days, after which a mixture of collodion and 
glycerine should be applied thickly over each 
pustule, renewed occasionally until desquamation 
has been completed. 

As there is no contagion so powerful or so 
certain as that of small-pox, suitable disinfectants 
should be freely used. (See How to Prevent 
the Spread of infectious Diseases, and Instructions 
for Disinfection. ) AncJ all persons should be 
vaccinated with pure bovine virus, and thus pre¬ 
vent the spread of the loathsome disease. A 
small quantity of matter taken from a pustule of 
a small-pox patient, and inserted beneath the skin 
of a healthy person, gives rise to a much milder 
form of the disease than would arise by inhaling 
the contagious poison; this is called inoculation, 
and was extensively practised before the discovery 
of vaccination. 

Vaccine , or Cow-pox. A disease of the cow 
called vaccine, or cow-pox, communicated to man, 
generally destroys the susceptibility to small pox. 
In the few cases in which it does not afford 
complete protection, should small-pox occur, it 
will be in a very mild form, of short duration, 
unaccompanied by secondary fever, and devoid of 
danger ; it is then called varioloid. 

Cow-pox is transferred to man, and from one 
person to another, by inserting some of its virus 


Small-pox. 


293 


or lymph under the skin, or applying it to an 
abraded surface; this operation is called vaccina¬ 
tion, and its value as a means of preventing the 
spread of small-pox was made known to the world 
in 1798, by Edward Jenner, an English physician. 

If all persons were properly vaccinated with 
pure vaccine matter, small-pox, the most loathsome 
pestilence, would soon be unknown. After an 
individual has been vaccinated, if the operation 
has been successful, the part becomes inflamed 
about the third or fourth day. This inflamed spot 
increases in size, and in its centre a distinct 
vesicle is formed about the fifth or sixth day, with 
an elevated edge and depressed centre; it is of 
pearl color and distended with lymph on the eighth 
day, when the constitutional effects — headache, 
loss of appetite, slight chilliness, etc. — begin to 
appear, but they subside in a day or two. The 
fluid then dries up, and a dark-brown scab forms 
which remains for about two weeks, leaving a cir¬ 
cular, depressed scar, permanent in after life. 

Vaccination when not properly performed, or 
when bad matter is used, is often the means of 
engrafting upon the constitution some impure dis¬ 
ease ; therefore vaccine virus of a doubtful char¬ 
acter should never be used. The only safe plan 
is to use, with a perfectly clean lancet, nothing 
but the pure matter obtained direct from a healthy 
young heifer. 


294 


The Eruptive Fevers. 


Although many persons are protected by one 
good vaccination for life, every individual should 
be vaccinated at least three times during a life 
time -— once in infancy, once after puberty, and 
once when about forty-five or fifty years of age. 
It is also a safe precaution to re-vaccinate at any 
time in case of known exposure, or when small¬ 
pox prevails as an epidemic. Re-vaccination is the 
readiest and safest test of insusceptibility to small¬ 
pox ; and when properly performed with pure 
virus can do no harm. 

Chicken-pox. Chicken-pox, or varicella, is a mild 
disease almost peculiar to infants and children 
under twelve years of age. It sometimes prevails 
as an epidemic; but it generally runs through 
all its phases in one week. 

It is slightly infectious, and after an incubation 
of four or five days from exposure to the conta¬ 
gion, small rose pimples form, as a rule widely 
scattered. These pimples become transparent ves¬ 
icles, filled with lymph, and surrounded by slight 
redness. About the fourth day the vesicles form 
small scabs which rapidly desicate: permanent 
pitting is a rare result. There is but little or no 
constitutional disturbance, and no danger to life. 
Precautionary treatment usually is all that is 
required. The patient should avoid exposure to 
cold and wet, keep the bowels regular, and the 
secreting organs in a state of healthy activity. 


Measles. 


295 


Measles. Measles, sometimes called rubeola from 
the red color of its eruption, is a continued infec¬ 
tious fever; the result of the absorption of, and 
contamination of the blood by, a morbid poison. 
After an incubation of from ten to fifteen days 
from exposure to its contagion, the disease com¬ 
mences with all the symptoms of a violent cold; 
sneezing, redness and watering of the eyes, run¬ 
ning at the nose, dry cough, hoarseness, etc. 
Chilliness, loss of appetite, lassitude, and all the 
ordinary symptoms of fever quickly follow. A 
crimson rash appears on the fourth day of the 
attack; first on the face and neck, and gradually 
extends over the body and limbs; it begins to 
fade on the seventh day of the attack in the same 
order, and is succeeded by considerable itching. 

Measles is frequently met with in children, 
occasionally in adults, and rarely in nursing infants. 
It is usually a mild and often a trivial disease; 
still it is sometimes accompanied by grave com¬ 
plications and serious sequels. It is important 
that it should be discriminated from other eruptive 
fevers as early as possible. 

False measles, sometimes called roseola or rose 
rash, is an eruptive fever of little importance. It 
lasts but a few days, requiring little treatment. 

German measles, so called, is a hybrid between 
measles and scarlet fever. In its severity it is 
similar to measles. 


296 


The Eruptive Fevers. 


The treatment of measles must not be too active ; 
palliative measures and attention to hygiene are, 
as a rule, all that is required. Mucilaginous drinks, 
gentle aperients and mild diaphoretics may be used. 
When the cough is troublesome, and there is much 
restlessness or vigilance, anodynes may be indi¬ 
cated. The eyes should be protected from the light, 
and if necessary the patient should be kept in a 
dark, but properly ventilated room. The applica¬ 
tion of a mustard draft tc> the chest, and also a hot 
mustard foot bath may sometimes be required. 
Debility may oftentimes require tonics during con¬ 
valescence. 

Scarlet Fever. Scarlet fever or scarlatina, so 
called from the color of its eruption, is remark¬ 
able for the wide diversity which it presents in 
different cases as regards symptoms and fatality. 

It has been divided into three varieties; viz. : 
scarlatina simplex, in which there is a florid rash 
and little or no affection of the throat; scarlatina 
anginosa, in which both the skin and throat are 
decidedly implicated; and scarlatina maligna, in 
which all the force of the disease seems to be 
expended upon the throat. 

Scarlet fever in its mildest form is a trivial 
affection ; but in its severest form there are few 
diseases more appropriately styled malignant. It 
occurs most frequently in the third and fourth 
year of life, the liability to it is diminished after 


Scarlet Fever. 


29 7 


the fifth year, and becomes very small after forty. 
As a rule, the susceptibility of the disease is 
destroyed by one attack. 

An attack of the disease usually commences 
(after an incubation of about five days from expos¬ 
ure to its cause) with shivering, lassitude, head¬ 
ache, and pains in the back and limbs, followed by 
more or less fever, restlessness, loss of appetite, 
nausea and vomiting. The throat may be sore 
on the first day, and on the second the eruption 
begins to come out, though in some of the worst 
forms it may be deferred to the fourth day. It 
is of a scarlet, or sometimes a brick-red hue, 
uniformly diffused, with a swollen appearance and 
great heat. The tongue has a strawberry-like look 
from the projection of enlarged red papillae through 
a whitish fur. 

In the favorable cases the eruption remains 
three or four days and then begins to fade, becoming 
by degrees indistinct, and disappearing altogether 
in the majority of instances before the end of the 
seventh day. In scarlatina anginosa the throat 
becomes foul and sloughy, and the disease is often 
threatening and serious. In scarlatina maligna the 
eruption, if it appears at all, is livid or partial, 
fades early and is attended with a feeble pulse, 
a cold skin, and extreme prostration of strength. 
Recovery from this variety of scarlet fever is the 
exception, however, and sometimes the patient sinks 


The Eruptive Fevers. 


298 

under the virulence of the poison in a few hours. 

Scarlet fever has a tendency to give rise to other 
diseases; those who have suffered from it may after¬ 
wards be afflicted with boils, strumous ulcers, various 
forms of scrofula, dropsy, etc. 

The treatment of scarlet fever in the majority 
of cases should be chiefly hygienic. Pure air, cool¬ 
ing drinks, an unstimulating diet, proper clothing, 
maintaining the functions of the skin, and atten¬ 
tion to the bowels are > the essentials. Medical 

advice, however, should always be obtained, for 
troublesome sequels may occur even in mild cases. 
Exposure to cold is to be avoided, both while the 
disease is in progress, and during convalescence, 
but care in this respect should not lead to error 
in the way of free ventilation. Warm baths may 
be given early in the progress of the disease, as 
it brings out the rash, reduces the temperature, 
and soothes the patient. The patient may be kept 
in the bath from three to five minutes, then 

rapidly dried, wrapped in flannel and returned to 

bed. 

The sore throat, which is specific in character, 
may require the use of local alteratives, and of 
chlorate of potassa internally. An old and popular 
gargle is the red pepper tea spoken of on page 

172. Iced drinks are useful in giving temporary 
relief. Tincture of iodine may be applied exter¬ 
nally to glandular swellings in the neck. The 


Erysipelas . 


299 


only chance of success in the treatment of malig¬ 
nant scarlet fever lies in stimulation. The vital 
powers are so prostrated by the deadly force of the 
poison, that unless they are supported by the judi¬ 
cious use of wine, brandy, or whiskey, they will fail 
altogether. 

Erysipelas. Erysipelas is a miasmatic disease due 
to the absorption of a specific poison ; it is charac¬ 
terized by a low form of fever, with a diffuse 
inflammation of the skin, or subcutaneous areolar 
tissue, or of both together. 

•It can be generated by inattention to sanitary 
laws ; it is infectious, and spreads by fomites; and 
sometimes prevails epidemically. It may attack any 
portion of the surface of the body, and is called 
erysipelas from its tendency to spread to adjoining 
parts. When it prevails epidemically, intemperance, 
insufficient food, foul air and wounds or injuries 
favor its occurrence. When the disease arises from 
internal causes — idiopathic erysipelas — it most 
frequently attacks the integuments of the head and 
face. When it follows wounds — traumatic erysip¬ 
elas— it commences at or around the seat of 
injury. 

Idiopathic erysipelas begins with a cold stage, 
followed by fever and general constitutional dis¬ 
turbance. On the second or third morning, a red 
spot, accompanied by burning heat and slight 
swelling, appears in some part of the body and 


300 


The Eruptive Fevers. 


spreads like a slow conflagration from part to part. 
When it appears on the face, the cheeks enlarge, 
the lips swell, the eyes become closed by their 
puffy lids, and the features are distorted. Delirium 
is common when the scalp is the seat of the 
eruption. 

The disease has no definite period of duration, 
but in mild cases the redness fades, the swelling 
subsides, and the cuticle desquamates in the course 
of a few days. The inflammation is merely super¬ 
ficial in most cases, and the disease is spoken of 
as simple or cutaneous erysipelas; but occasionally 
the subcutaneous connective tissue is involved, 
and suppuration, sloughing, or gangrene, may result; 
the disease is then spoken of as plegmonous or 
cellulo-cutaneous erysipelas. Erysipelas that follows 
wounds combines the danger of the disease itself 
with that of the injury or local affection from 
which it starts. 

Death may result from erysipelas by a failure 
of the vital powers, or by the inflammation and 
swelling extending to the neck and throat, giving 
rise to suffocation ; or by the extension of the 
inflammation to the brain and its membranes 
giving rise to effusion and coma. 

The diet of those afflicted with erysipelas should 
be light, but nourishing; they should have plenty 
of pure air, but advoid drafts ; and ice and cool¬ 
ing drinks may be allowed. A mild laxative may 


Erysipelas. 


301 


be given at the commencement of the disease, 
and if the system is enfeebled, iron, quinine, or 
other tonics, or perhaps even stimulants, may be 
required. 

To prevent erysipelas from spreading, boundary 
lines may be drawn on the sound skin with tinc¬ 
ture of iodine or nitrate of silver; or what is 
perhaps better in most cases, is to paint around 
the affected part a solid ring of collodion. A 
strong solution of tannin or a saturated solution 
of boracic acid may be freely applied to the 
inflamed skin in some cases. The former is not 
disagreeable to the patient, and the latter is 
soothing and devoid of smell or staining qualities. 
Cranberry poultices often “act like a charm,” 
when used for deep-seated cellular erysipelas, but 
are not of much value in other erysipelas. It 
perhaps is unnecessary to add that the treat¬ 
ment of erysipelas, like that of most other diseases, 
varies with the nature of the disease and the 
condition of the patient. 


VI.—DISEASES OF THE NERVOUS SYSTEM. 


As the nervous system presides over and gov¬ 
erns the entire body, the diseases to which it is 
liable, exerts a more extensive influence than any 
other bodily affliction. The mind and body recip¬ 
rocally act upon each other; therefore, to avoid 
nervous diseases, it is not only essential that 
attention be given to the state of the body, but 
it is of the utmost importance that a calm and 
uniform state of mind, one not easily disturbed 
by the crosses and accidents of life, be maintained. 

The greater part of the diseases affecting the 
nervous system relate to the nervous centres — 
the brain and spinal cord; still, some important 
affections are seated in the nervous trunks or 
their branches. 

The simplest division of nervous diseases is into 
two kinds; viz: structural and functional. The 
former arising from some morbid change or lesion 
in the nerve structure ; the latter including those 
in which there is no structural change to account 
for the symptoms. 

Structural diseases may again be divided into 

two kinds; viz: those affecting the nerve centres, 

302 


Inflammation of the Brain. 


303 


and those affecting the nerves. The nerve centres 
are subject to diseases affecting their covering or 
membranes, their substance and their bloodvessels; 
some of the most important diseases of the brain 
and spinal cord have their point of departure 
in the membranes. Although the nervous system 
has diseases peculiar to itself, the brain and its 
membranes are subject to morbid conditions essen¬ 
tially the same as in diseases of the other parts of 
the body; viz.: congestion, inflammation, hemorrhage, 
and various structural lesions. 

Functional diseases of the nervous system mani¬ 
fest themselves by irregular, depressed or exalted 
conditions of the processes and functions of the 
system ; viz. : the mental faculties, special and gen¬ 
eral sensibility, voluntary motion, involuntary or 
reflex movements, and innervation. 

Inflammation of the Brain. When the parts 
within the cranium — either the substance of the 
brain, or its membranes, or both — are inflamed, the 
condition is commonly spoken of as inflammation 
of the brain. 

Inflammation of the membranes of the brain — 
meningitis—and of the substance of the brain — 
cerebritis — although distinct affections, are usually 
associated ; inflammation of the membranes having 
a tendency to spread to the substance of the brain, 
or the reverse obtaining; the co-existence of the 
two affections being called meningo-cerebritis, 01 


304 


Diseases of the Nervous System. 


encephalitis. It most frequently occurs in males 
between fifteen and forty-five years of age. Hot 
climates, and intemperate living, predispose to it. 
Exciting causes are external injuries, as blows or 
falls upon the head, and exposure to the sun, 
violent or prolonged mental excitement, erysipelas 
of the head, etc. Its symptoms are fever, intense 
headache, nausea and vomiting, redness of the 
face and eyes, an excited look, dizziness, roaring 
in the ears, sharp, hard and irregular pulse, ex¬ 
treme sensitiveness to light and sound, restless¬ 
ness, wakefulness, confusion of thought or even 
wild delirium ; the bowels are usually constipated. 
These symptoms are most marked when the 
meningitis predominates. 

The second stage, the period of collapse, sets 
in at the end of twelve, twenty-four or forty- 
eight hours. The patient’s vision and hearing 
become dull, his articulation difficult or indistinct, 
and he falls into a state of stupor. The coun¬ 
tenance gets ghastly, sordes form on the gums 
and teeth, the body becomes covered with cold 
sweats, and finally a few convulsive paroxysms may 
occur, followed by paralysis, profound coma and 
death. 

Fortunately, the disease is not of frequent 
occurrence, and although the majority of cases 
end in death, many recover under good treat¬ 
ment, 


Apoplexy. 


305 


In treating inflammation of the brain, the hair 
should be cut very short, cold water or ice 
applied to the head, and the hands and feet 
placed in hot baths ; bleeding is sometimes advis¬ 
able ; a mustard plaster may be applied to the 
back of the neck, and active cathartics and saline 
diuretics administered. The patient should be kept 
in a cool, dark, well-ventilated room, free from the 
slightest noise, and the diet should be light and 
unstimulating. 

Apoplexy. The common expression, “an apoplec¬ 
tic stroke," is applied to a state of coma occurrino- 

o 

suddenly, from pressure upon the brain ; the com¬ 
pressing power having its seat within the cranium, 
and usually consisting of blood that has escaped 
from a ruptured artery. 

Apoplexy is so called because those attacked fall 
down suddenly as if from a blow; it occurs chiefly 
at an advanced period of life, and is sometimes due 
to intense and suddenly developed congestion of the 
brain. The disorder is sometimes preceded by a 
flushed appearance of the face and eyes, dimness of 
sight, giddiness, headache, loss of memory, faltering 
of the tongue in speaking, numbness in the extremi¬ 
ties and drowsiness. Sudden stupor soon follows. 
In most cases, however, there are no well-defined pre¬ 
monitory symptoms — the patient being suddenly 
deprived of the exercise of all the senses, and of 
voluntary motion; the countenance becomes florid; 


306 Diseases of the Nervous System. 

the face appears swollen and puffed up; the blood¬ 
vessels of the neck and temples are turgid and 
distended with blood; the pulse is strong and 
full; the eyes are prominent and fixed; and the 
breathing is stertorous. 

The duration of the apoplectic fit varies from 
two or three hours to as many days; throughout 
which time there is total unconsciousness. The 
danger of the attack is somewhat in proportion to 
the depth of the coma, the amount t>f stertorous 
breathing and puffing out of the cheeks, the 
degree of prostration, and the difficulty of swal¬ 
lowing. Each succeeding attack becomes more 
dangerous, and a third is seldom survived. 

Those emerging from the apoplectic state appear 
as if awakened from profound sleep ; but gener¬ 
ally they are found to have more or less paraly¬ 
sis, and more or less impairment of the mind. 
The paralysis, in the maj'ority of cases, affects one 
side only, and is usually complete, the sensibility 
and the power of motion on 'the affected side 
being lost ; but in most cases it gradually returns 
until a certain point is reached, and at this point, 
which varies in different cases, the improvement 
stops, and the remaining paralysis is permanent. 
The impairment of the mind is shown in failure 
to express wants in proper language, in failure 
of memory, in childishness, in irritability and im¬ 
patience, and in the patient being more easily 


Paralysis. 


3o; 


influenced by others; weeping and mirthfulness 
are also excited by trivial causes. 

When a predisposition to apoplexy is suspected, 
the individual should avoid alcoholic drinks, violent 
mental emotion, excessive exercise, exposure to 
extremes of temperature, overloading the stomach, 
and in fact everything tending to induce an undue 
accumulation of blood in the vessels of the brain. 

During an attack of apoplexy the patient should 
have perfect rest in a cool, airy apartment, with 
the head raised and cold water or ice applied to 
it. Mustard plasters should be applied to the feet 
and calves of the legs; and in some cases, a 
powerful purgative may be administered — a drop 
or two of croton oil placed on the tongue per¬ 
haps, being the best. Bleeding, in a certain few 
cases, is beneficial, but will do harm if resorted 
to indiscriminately. The treatment after the at¬ 
tack will be considered under the head of par¬ 
alysis. 

Paralysis. The' term paralysis, or palsy, denotes 
loss or impairment of sensibility or motion, or 
of both, in one or more parts of the body. It 
is owing to some diseased condition, either of the 
brain or spinal cord or of the nerves. The most 
severe and dangerous form of the disorder is that 
which follows an apoplectic attack. 

Complete loss of sensation and motion of the 
whole system is general paralysis, but as this 


308 Diseases of the Nervous System . 

cannot take place without death immediately 
resulting, the term “general paralysis” is applied 
to palsy affecting the four extremities, whether 
any of the other parts of the body are implicated 
or not. 

When paralysis is limited to one side of the 
body, it is called hemiplegia; when it is confined 
to the lower extremities, it is called paraplegia; 
and when it affects only a small portion of the 
body, the paralysis is called local. 

The treatment of the several forms oi paralysis 
should be governed by the morbid conditions on 
which the paralysis is dependent, by co-existing 
affections in any part of the body, and by the 
state of the system. In a certain proportion of 
cases the paralysis depends on lesions which are 
irremediable, and but little can be done, either 
in the way of cure or alleviation. Among the 
most important means that may be adopted to 
rouse or restore the function of the paralyzed 
parts, to promote circulation in the parts, and to 
secure healthy nutrition, are friction, stimulating 
liniments, electricity, passive movements, strychnia, 
and exercise. The treatment should be directed 
intelligently and cautiously, or more harm than 
good will result. Electricity, although valuable in 
certain cases, should not be employed when there 
is structural disorganization, or it will do harm. 
Strychnia, when cautiously used in small doses, 


Sunstroke. 


309 


is beneficial in cases of functional paralysis; 
when used to relieve the paralysis following apo¬ 
plexy, it should be only after the acute stage has 
passed and the clot absorbed, or the clot may 
be excited into an irritating foreign body. 

Sunstroke. Sunstroke, or heatstroke, is a disease 
caused by exposure to the direct rays of the sun, 
or excessive heat. 

The direct rays of the sun upon the head, 
particularly while laboring or exercising actively 
on a hot day, may induce cerebral congestion, 
loss of consciousness and death in a few hours. 
In some instances the disease resembles apoplexy. 
Excessive heat not under the immediate influence 
of the sun may prostrate the vital powers, causing 
the forces which carry on the circulation to give 
way, and death to take place by syncope. This 
condition may be expressed by the term exhaustion. 

“The premonitions of the attack are slight or 
wanting. Doctor Swift in a report based on the 
observation of the cases in the New York Hos¬ 
pital, gives the following account of the attack: 

‘ The patients are suddenly seized, while in the 
performance of their labors, with pain in the 
head, and a sense of fulness and oppression in 
the epigastrium, occasionally nausea and vomiting, 
general feeling of weakness, especially of the 
lower extremities, vertigo, dimness of vision and 
insensibility. Surrounding objects appear of uni- 


310 Diseases of the Nervous System. 

form color. In a great majority of cases, so far 
as could be ascertained, blue or purple. In one 
instance everything appeared red ; in another 
green, and in another white.’ It is stated by 
Longmore that irritability of the bladder precedes 
the attack. The attack may consist of only tran¬ 
sient insensibility. But in severe cases the 
patient usually passes quickly into a comatose 
state.”— Flint's Practice Medicine , 3 d ed., p. 592. 

To prevent sunstroke anc> other serious effects 
of excessive heat, the body should be bathed in 
cold water every morning ; all intoxicating drinks 
should be avoided; but water, lemonade, and 
other simple diluents may be partaken of freely. 
The head should be kept wet with cold water, 
and when exposed to the sun covered with a 
light hat or thin folds of white linen kept wet. 
The natural perspiration should not be checked, 
the clothing should be light and loose, and the 
meals should be at regular hours. Should a sense 
of pain or tightness about the forehead, dizziness 
or weakness be experienced, the sufferer should 
retire into the shade and bathe his head with cold 
water. 

The treatment of sunstroke or heatstroke con¬ 
sists in keeping the patient in as cool and pure 
an atmosphere as possible; to removing every¬ 
thing constricting the chest or neck, and apply¬ 
ing ice or cold water to the head which should 


Headache. 


311 

be slightly elevated. Careful discrimination should 
be made between those cases called heat apoplexy 
and those called heat exhaustion ; for certain 
methods of treatment that would be of the 
greatest benefit to one, would be of the greatest 
injury to the other. When there is cerebral con¬ 
gestion or heat apoplexy, the bowels should be 
freely opened with a dose of croton oil, or an 
enema; bleeding may also be required in some 
cases, and revulsive applications should be made 
to the extremities. Cathartics, bloodletting, and 
all depressing agencies do harm in heat or ner¬ 
vous exhaustion, and should be avoided in such 
cases, and aromatic spirits of ammonia, or a small 
quantity of alcoholic stimulants administered: these 
are especially indicated when there is danger of 
death by rapid asthenia or syncope. 

Complete rest is of the first importance in 
both class of cases. Those cases in which there 
are convulsions, twitchings, delirium or general 
excitement, are greatly benefitted by the hypoder¬ 
mic injection of morphia. 

After consciousness has returned the patient 
should avoid all excitement, and may be given 
bromide potassium, which has been found the 
most proficient of the numerous drugs employed. 

Headache. Headache, or pain in the head, is of 
very common occurrence; it is present as a symp¬ 
tom during some part of the progress of most acute, 


312 Diseases of the Nervous System. 

and many chronic diseases. There are but few 
persons who do not occasionally experience an 
attack, and there are very many who are subject 
to attacks recurring sometimes at regular, but 
usually at irregular intervals. 

Headache may be divided into four principal 
varieties ; viz. : organic headache , due to disease 
of the brain or its membranes ; plethoric headache , 

dependent upon fulness of blood ; bilious headache, 

\ 

caused by errors of diet, a weak stomach, indiges¬ 
tion, lack of exercise, and ill-performed functions 
of the liver; and nervous headache , due to debil¬ 
ity and exhaustion. 

“ Headaches of whatever kind occur more fre¬ 
quently in persons of adult life than in extreme 
youth or advanced age; and in the brain workers 
rather than among mechanics. Their occurrence is 
favored by hereditary predisposition. Habitual dwell¬ 
ers in towns suffer more than residents in the 
country; females more than males, the nervous and 
delicate more than the robust, and the middle 
and higher classes of society more than the lower. 
And then lastly, Dr. Wright says that all pains 
in the head ‘ especially affect persons who neg¬ 
lect the many little attentions and cares that our 
civilized, and therefore in some measure, artificial 
mode of life requires. I may especially instance 
regularity in diet, carefulness in adapting the 
clothing to the requirements of our variable climate, 


Headache. 


313 


attention to the action of the bowels, and a suffi¬ 
cient amount of exercise, as essential objects of 
our care.’ ”— Tanners Practice Medicine , 5 th Amer¬ 
ican ed.y p. 397. 

The treatment of headache consists in keeping 
the head cool, the feet warm, the bowels regu¬ 
lar, and the use of such remedies, both internal 
and external, as the particular variety of head¬ 
ache may require. 

When the headache occurs as a symptom in 
the course of some disease, the disease itself 
should be treated, and nothing more than pallia¬ 
tive measures should be resorted to for the relief 
of the headache. 

The treatment of periodical headache embraces 
measures to be employed at the time of the 
attack and during the intervals. Evaporating 
lotions applied to the head at the time of the 
attack, and the inhalation of a little of the vapor 
of chloroform often give immediate relief. Among 
the most valuable remedies used for various forms 
of headache are valerian, valerianate zinc, valeria¬ 
nate ammonia, aromatic spirits ammonia, guarana, 
bromide potassium and bromide camphor. Hygienic 
measures are important in the treatment of head¬ 
ache as well as many other diseases : the more 
the laws of health are observed the less the lia¬ 
bility to attacks of the disorder. 

Insanity. Of all our afflictions insanity is the 


3 T 4 Diseases of the Nervous System. 

greatest; but what is insanity ? Many attempts 
have been made to define it, but most of the 
definitions given are imperfect. It would be difficult 
to find one which includes all who are insane 
and excludes all who are sane. This difficulty is 
accounted for by the fact that in the early stages 
of insanity the mind often fluctuates between 
sanity and insanity ; the shades of disordered intel¬ 
lect being so blended as to be scarcely distin¬ 
guishable from a state of sanity; and even in 
cases of insanity of long standing the mental dis¬ 
order varies greatly in its degree and character. 

It is difficult to fix upon a standard by which 
a fair comparison can be made between sanity and 
insanity, because the mind differs in its power 
and manifestations in most persons. It is common 
to measure the cultivation and rationality of men 
by their knowledge; but this differs in different 
men according to the objects which most engage 

their minds ; and by these objects its worth must 

/ 

be judged. Knowledge, however, does not consti¬ 
tute sanity, nor ignorance insanity. A lunatic 
may be either ignorant or educated, and has been 
defined to be an individual who reasons correctly 
from false premises ; yet we know that not only 
many sane persons do this, but one who is insane 
often reasons falsely from the objects presented 
to his senses, or from his own fancies. 

“ The terms insanity, lunacy, unsoundness of 


Insanity. 


315 


mind, mental derangement, mental disorder, mad¬ 
ness, and mental alienation or aberration, have been 
indifferently applied to those states of disordered 
mind in which a person loses the power of regu¬ 
lating his actions and conduct according to the 
ordinary rules of society. In all cases of real 
insanity, the intellect is more or less affected — 
hence the term intellectual insanity. In a medical 
sense this implies a deviation of the mental faculties 
from an assumed normal or healthy standard. In 
an insane person there may be no bodily disease, 
but his language and habits are changed — the 
reasoning power which he may have enjoyed in 
common with others is lost or perverted, and he 
is no longer fitted to discharge those duties which 
his social position demands. Further, from perver¬ 
sion of reason, he may show a disposition to com¬ 
mit acts which may endanger his own life or the 
lives of those around him. It is at this point 
that the law interferes for his own protection and 
for that of society.’’ — Taylors Medical Jurispru¬ 
dence , 2 d English ed., Vol. II. p. 476. 

. . . “ Insanity consists of a functional or 
organic disease of the gray matter of the cerebral 
hemispheres ; this disease giving rise to illogical or 
erroneous ideas, to disordered actions, and to that 
general mental condition which hinders a man 
from discharging his duties to his God, his neigh¬ 
bor, and himself. This definition is open to many 


316 Diseases of the Nervous System. 

objections; and let doctors and lawyers vex them, 
selves as they may, every endeavor to form one 
will be so. For as nothing can be more slightly 
defined than the line of demarkation between sanity 
and insanity, so if we make the definition too 
narrow it becomes meaningless, and if too wide 
the whole human race may be involved in it.” — 
Famiers Practice Medicine , 5 th American ed., p. 372. 

Insanity is usually divided into four varieties; 
viz. : mania, monomania, dementia and idiocy. In 
some instances a particular case cannot be assigned 
to either of these divisions, which is owing to the 
fact that the first three of these states of dis¬ 
ordered mind are frequently intermixed, and are 
apt to pass and repass into each other; a case 
may also represent mixed characters which apper¬ 
tain to the four divisions. 

Mania, or raving madness, is that form of insanity 
in which there is general derangement or perversion 
of the mental faculties, accompanied by greater 
or less excitement, sometimes amounting to violent 
fury. The reasoning faculty is disturbed, confused, 
or completely lost. The ideas are abundant, erro¬ 
neous, absurd, and flow through the mind without 
order or connection; as they are not under control, 
the poor victim believes and acts upon them, however 
absurd and inconsistent they may be. There is 
rapidity of utterance, incessant agitation, great irrita¬ 
bility, and not the least contradiction can be borne. 


Insanity. 


3i; 


Mania usually comes on gradually, but sometimes 
it makes its incursion suddenly, as after a violent 
moral shock. When the disease is slowly devel 
oped, various premonitory symptoms, such as neg¬ 
lect of family and business, change of moral char¬ 
acter, distrust of friends, fits of passion, despon¬ 
dency, sleeplessness, etc., occur. Mania may be 
acute or chronic, recurrent or continued. The 
excessive physical exertion which maniacs go through 
with in their fierce, rapid, and destructive a'cts, 
and, when talking, shouting, howling, laughing, 
reciting, etc., for hours at a time, together with 
their persistent sleeplessness, and perhaps aversion 
to food, soon makes them weak and emaciated. 
There are but few cases, however, in which there 
are not remissions more or less complete; and 
in some instances after a violent attack, the reason 
appears to be perfectly restored, forming then what 
is termed a lucid interval. More than half of 
the first attacks of mania are recovered from under 
good management. The hope becomes less with 
each repetition, and also in proportion to the dura¬ 
tion of chronic mania. Recovery occasionally takes 
place, however, in those who have been insane for 
years. 

Monomania, or partial insanity, is that form in 
which the disorder is confined chiefly to one sub¬ 
ject, or one class of subjects. Monomaniacs have 
false ideas on certain points of which they can- 


318 Diseases of the Nervous System. 

not divest themselves, and out of which they can¬ 
not be reasoned. They start from false principles, 
but their inferences and deductions from these 
principles often possess logical accuracy. The mind 
of a maniac is disordered on all subjects, but the 
mind of a monomaniac is like a sane person’s in 
those particulars not connected with his special 
delusion. 

Dementia, or incoherence, is that condition in 
which a general weakness of the intellect, induced 
by disease or age, is a prominent feature. It 
usually comes on gradually — the faculties decaying 
one by one ; but in some instances it may occur 
suddenly from a violent shock or impression on 
the mind. 

In confirmed dementia there is total absence of 
all reasoning power; an incapacity to perceive 
the true relation of things ; a loss of memory and 
inconsistent actions and incoherent language. The 
patients speak without being conscious of what 
they are saying; their manners are undecided, 
childish and silly ; and they are ignorant of time, 
place, quantity, property, etc. They have neither 
partialities nor aversions ; neither hatred nor affec¬ 
tion. They see their best friends without pleas¬ 
ure, and they leave them without regret. 

Dementia varies in degree, and may be acute 
or chronic, remittent or intermittent. One form 
of the disease is the disordered mind of aged 


Insanity. 


319 


persons who may possess momentary mental power 
and a certain amount of memory, although the 
latter is restricted to objects long since past. 
Some persons in dementia are quiet, others are 
in constant motion, as if in search of something. 
Dementia is very rarely, if ever, cured, and in its 
last stages there is complete paralysis. The ulti¬ 
mate tendency of mania and monomania is to pass 
into dementia. 

Idiocy is characterized by partial or complete 
absence of the intellect, owing to imperfect organ¬ 
ization of the brain. It differs from the other 
states of insanity in the fact that the sufferer 
has never had mental power, the defect in the 
structure of the brain having been inherited. 

Idiots have a vague, unmeaning look, without 
the least approach to intelligence. They have but 
little or no power of speech, their minds seem 
to be a blank, and their actions depend upon 
impulse, or mere animal instinct. There is a 
state, scarcely separable from idiocy, called imbe¬ 
cility, in which the mind is capable of receiving 
some ideas, and of profiting to a certain extent 
by instruction. The mind of an imbecile, how¬ 
ever, is*not capable of being brought to a healthy 
standard of intellect like that of an ordinary per¬ 
son of similar age and social position. 

“Idiocy and imbecility must not be confounded 
with mania and monomania. In idiots and imbe- 


320 Diseases of the Nervous System . 

ciles, ideas are wanting, and the power of thought 
is absent or deficient; in maniacs and monoma¬ 
niacs the ideas flow freely, but they are perverted, 
and the power of thought is irregular and uncon¬ 
trolled. In idiocy and imbecility we do not meet 
with the hallucinations and illusions which consti¬ 
tute the main features of mania and monomania. 
Idiocy is much more likely to be confounded with 
dementia, and indeed when dementia is confirmed 
and complete (fatuity) there is no appreciable 
difference, for in neither state is there any evi¬ 
dence of the exercise of mental power. 

“ In idiocy no ideas have ever been formed ; 
in imbecility they have been partially formed, but 
arrested; in dementia they have been more or 
less completely formed, but have subsequently 
become entirely obliterated. It is important to 
remember that in idiocy and imbecility there is 
no gradual loss or impairment of faculties, as is 
generally observed in dementia ; the person is what 
he always has been — mentally weak and unsus¬ 
ceptible of any great degree of improvement by 
instruction.” — Taylor s Medical Jurisprudence , 2 d 
Eng, ed., Vol. II. p. 504. 

The treatment of the insane has much improved 
during the past few years; they are no longer 
loaded with chains and confined in dungeons, but 
are treated with kindness and consideration, and 
allowed all the liberty that the nature of their mal- 


Convulsions. 


321 


ady admits of. The means adopted to effect a 
cure naturally resolve themselves into medical and 
moral; but it is not a good plan, as a general 
rule, for the friends of an insane person to 
assume charge of his case and endeavor to cure 
his affliction at home. Insanity should be treated 
only by those who make it a special study and 
are experienced in the business. The greatest 
hope of cure lies in the early removal to a well- 
conducted asylum or hospital for the insane where 
everything is arranged especially with a view to 
the most favorable effect upon its inmates. 

Convulsions. Convulsions, or “fits,” consist of 
violent, involuntary contractions of the muscles 
of the body, occurring in paroxysms, and usually 
associated with insensibility. There are but few 
symptoms accompanying disturbances of the ner¬ 
vous system, which cause greater alarm to the 
friends of the patient, than an attack of convul¬ 
sions. Probably this is due to the suddenness 
with which the paroxysm occurs, the distortion 
of countenance which it produces, and the loss 
of consciousness that attends it. 

Convulsions occur most frequently during the 
first eight years of life. They are produced by 
a variety of circumstances, prominent among 
which we may mention teething, indigestion, 
worms, constipation, sudden fright and disease 
of the brain. Those causes which produce delirium 


322 Diseases of the Nervous System . 

in an adult, also produce convulsions in an infant. 

Infants often suffer from what are commonly 
called “inward fits.” When they occur the baby 
lies as if asleep, but rolls its eyes, moves the eye¬ 
lids, breathes with a little difficulty, moans gently, 
the muscles of the face twitch slightly, there is 
the so-called “sardonic smile,” and sometimes 
there is a livid ring around the mouth. This 
condition arises from flatulence and indigestion, 
and is a warning that the quality of the food 
should be attended to. It is usually relieved by 
gentle friction over the abdomen, together with 
the administration of two or three drops of the 
tincture of cardamons, or aromatic spirits of 
ammonia. 

The treatment of convulsions will vary according 
to the circumstances of each case. We should 
ascertain the cause of the attack, and treat that. 
Loose clothing, fresh air, cold applications to the 
head, and hot applications to the feet, or a warm 
bath, are beneficial during the fit. Ice, nor wet 
cloths, shouid not be kept on the child too long, or 
they will do harm. When the stomach contains 
undigested food, emetics will be needed ; when there 
is much flatulence, carminatives ; and when the bowels 
are confined, gentle antacid purgatives. If the irri¬ 
tation is due to dentition, and the tense swollen 
gums appear to offer an obstacle to the passage of 
the teeth, they should be lanced. If there are in- 


Epilepsy. 


323 


testinal worms, they should be got rid of by the 
use of suitable drugs. (See Intestinal Worms. ) 

Epilepsy. Epilepsy is a disease characterized by 
periodical convulsions, with unconsciousness during 
the attack. The patient may apparently be in ordi¬ 
nary health, engaged in his usual occupations, when 
suddenly, without warning, he may utter a piercing 
scream, or a suppressed groan, and fall to the ground 
senseless, violently convulsed. 

The disease is commonly called “the falling sick¬ 
ness,” or “fits.” The ancients called it “the sacred 
disease;” they supposed, from the suddenness of its 
attack, that it was due to the influence of the gods 
or evil spirits. 

Although epilepsy usually comes on suddenly, 
there are sometimes warnings of its approach; 
these may be irritability, headache, dizziness, 
noises in the ears, and floating specks before the 
eyes; there is also a peculiar sensation, called the 
epileptic aura, which is felt by some immediately 
before the attack; this is variously described as a 
creeping or blowing sensation, like that of a current 
of air, or stream of water, or slight convulsive 
tremor, beginning in the hand or foot, and 
extending upward to the head, when the patient 
is deprived of all consciousness. During the attack 
the face is flushed, the eyeballs roll, and there 
is gnashing of the teeth and frothing at the 
mouth, 


324 


Diseases of the Nervous System . 


The duration of the paroxysm is usually from 
five to ten minutes, but occasionally several 
attacks follow each other in rapid succession, and 
the patient is unconscious for hours. As the 
convulsive movements gradually diminish, the 
patient may recover a faint glimmering of con¬ 
sciousness ; but the look which he * casts around 
is stupid and heavy, and he immediately falls 
into a deep sleep, which may be protracted for 
hours, and from which he awakes exhausted, and 
with slight mental confusion or headache, but 
without any knowledge of what he has gone through. 

The periods at which the seizures recur, are 
variable. Repeated attacks of the disease soon 
produce a marked change in the mental and 
physical character of the individual; it has a 
tendency to impair the memory, to weaken the 
understanding, and to produce a sense of mental 
depression and melancholy. 

The tendency to epilepsy is often hereditary. 
Among the most frequent exciting causes are sud¬ 
den fright, blows upon the head, intestinal worms, 
intemperance, etc. The disease is rarely fatal when 
uncomplicated. The patient is liable, however, to 
injure or kill himself by falling in some dangerous 
position ; his tongue also, may be severely bitten 
during the paroxysm ; this may be avoided by 
placing a piece of rubber or cork or soft wood 
between the teeth. 


Hysteria. 


325 


During an attack very little is to be done beyond 
loosening the patient’s clothing, placing him in a 
comfortable position and giving him plenty of fresh 
air. In the interval between the attacks the patient 
should carefully observe the laws of health in 
respect to diet, air, sunlight, bathing, sleep, exercise, 
and should practise moderation in the indulgence 
of his passions. Chief among the remedies are 
bromide and iodide of potassium,* and bromide of 
ammonium ; these may be prescribed in such doses 
as the particular case may require; it is a good 
plan to combine them in a solution with tincture of 
rhubarb and compound syrup of sarsaparilla. When 
the appropriate remedies are judiciously employed, 
and a proper regimen strictly adhered to, epilepsy 
is often permanently cured. 

Hysteria. Hysteria is a nervous affection to which 
unmarried females of weakly constitutions between 
the ages of fifteen and forty-five are particularly 
liable. 

The attack is usually preceded by headache, 
dejection of spirits, anxiety of mind, difficulty of 
breathing, restlessness, cramps, coldness of the feet, 
yawning, and sometimes by immoderate fits of 
laughing or crying alternately. The patient often 
experiences a peculiar sensation as if a ball were 
advancing upward from the stomach into the throat, 
threatening to stop the passage of air : then the 
trunk and limbs of the body become violently 


326 Diseases of the Nervoits System. 

convulsed, the breathing becomes hurried, the 
heart palpitates and the patient sobs and cries 
and occasionally bursts into fits of laughter. The 
patient may assume a variety of positions, tear 
her hair, beat her breast, perhaps vomit a little, 
and be troubled with a distressing hiccough. The 
face is pale and flushed, alternate in delicate 
females; in the more robust it is flushed and 
appears fuller than usual. ■» 

The duration of an attack varies from a few 
moments to several hours; when the symptoms 
susbide, a quantity of wind is evacuated upwards, 
with frequent sighing and sobbing, and the patient 
gradually recovers ; feeling, however, severe pain 
in the head, soreness all over the body, and an incli¬ 
nation to lie in a languid and listless state for 
some time. 

Hysteria assumes such a variety of symptoms 
that an adequate idea of it cannot be conveyed 
in a concise description; but a minute account 
of all its various forms and relations is unneces¬ 
sary, for however alarming and dreadful it may 
appear, it is rarely attended with any danger to 
life. It is very important, however, that it should 
be distinguished from other diseases. 

The first care during a paroxysm is to prevent 
the patient from injuring herself by the violence of 
her struggles. If the fit be slight it may frequently 
be arrested by the sudden and free application of 


Hysteria. 


32 ; 


cold water to the head and face; or by putting 
salt or something of an unpleasant taste in the 
mouth; or by applying some stimulating scent to 
the nostrils. The patient’s clothing should be 
loosened and she should have, plenty of fresh air. 
When the paroxysm is severe, there are various 
drugs, such as valerian, tincture valerianate ammonia, 
compound spirit of ether, and assafoetida, which 
may be administered with benefit. 

After recovery from the attack the patient’s 
general health should be improved; she should 
seek agreeable company, keep her mind as cheer¬ 
ful and tranquil as possible, and all tendency to 
excess or irregularities kept in check. Hot rooms 
and late evening parties should be avoided. 
When there is plethora or fulness of blood, a 
spare diet, exercise, and occasional laxatives are 
recommended; but when there is a deficiency of 
blood, a nourishing diet, tonics, bathing, out-door 
exercise and recreation are beneficial. 

Chorea or St. Vitus's Dance. Chorea or St. ' 
Vitus’s Dance is characterized by irregular, trem¬ 
ulous, and often ludicrous actions of the volun¬ 
tary muscles over which the will has but partial 
control. It occurs most frequently in young girls 
between the age of six and sixteen ; it commences 
with slight muscular twitchings which gradually 
increase in severity until the patient cannot walk 
without a jerking movement and staggering. 


328 Diseases of the Nervous System. 

There is constant restlessness and the child finds 
it almost impossible to keep quiet; the muscles 
of the face twitch grotesquely and the speech 
may be affected. The irregular muscular actions 
almost invariably cease during sleep. 

Chorea may last from one week to several 
months, and in some cases it has been known to 
continue through life. Although most common in 
girls, yet boys sometimes suffer from it. It is 
not dangerous to life, and when it occurs in 
young persons it generally terminates favorably in 
a few weeks under proper treatment ; relapses, 
however, are liable to occur. 

The most frequent cause of chorea is fright ; 
but nervous debility is nearly always present 
before the attack. Excessive mental excitement 
when fatigued, and any irritation of the nervous 
system, may produce it. 

The treatment of Chorea consists in the 
administration of tonics, aperients, and anti-spas- 
modics, with good diet, sea-water bathing, and out¬ 
door exercise. Iron and arsenic are valuable 
remedies in many cases. 

Tetanus. Tetanus is a disease characterized 
by a violent, rigid and painful contraction or 
spasm of many or all of the voluntary muscles. 

Persons of all ages and of both sexes are liable 
to its attack, which frequently arises from some 
irritation of the nerves in consequence of local 


Tetanus. 


329 


injury by puncture, incision or laceration; the 
disease may also be produced by exposure to 
cold and dampness. 

Tetanus may come on suddenly with great 
violence, but more frequently its attack is gradual, 
beginning with slight stiffness in the back part 
of the neck, which increases and ultimately ren¬ 
ders the motion of the head difficult and painful. 
An uneasy sensation is felt at the root of the 
tongue, which increases until the muscles about 
the jaws get involved, and the teeth become so 
closely set together as not to admit of the 
slightest opening. This is the most common form 
of the disease, and is called locked-jaw or trismus. 
When the disease extends further, the remaining 
muscles of the face, those of the trunk, and lastly 
those of the extremities, become affected so as to 
forcibly bend the body either backward or forward 
in the shape of an arch. Strychnia in poisonous 
doses produce symptoms which resemble those of 
tetanus. 

“The suffering caused by the tetanic spasms is 
absolutely frightful to contemplate. The face be¬ 
comes deadly pale, and the brows get contracted ; 
the skin covering the forehead is corrugated ; the 
eyes are fixed and prominent—sometimes suffused 
with tears; while the nostrils are dilated, the cor¬ 
ners of the mouth drawn back, the teeth exposed, 
and the features fixed in a sort of grin — the 


330' Diseases of the Nervous System. 

risus sardonicus. The respirations are performed 
with difficulty and anguish; severe pain is felt at 
the sternum; and there is great thirst, but the 
agony is increased by attempts at deglutition. The 
pulse, too, is feeble and frequent; the skin is 
covered with perspiration, and the patient cannot 
sleep, or if he dozes, it is only for a few minutes 
at a time. Yet with all this suffering the intel¬ 
lect remains clear and unaffected. 1 Death at length 
ends the agony, the release being due partly to 
suffocation and partly to exhaustion.” — Tanners 
Practice Medicine , 5 th American ed., p. 460. 

The modes of treatment indicated by the dis¬ 
ease are: 1st. The removal of any local irritation 
which may appear to have excited it; 2d. Les¬ 
sening the general irritability and spasmodic ten¬ 
dency ; and 3d. Restoring the tone of the system. 
The remedies upon which the most reliance can 
be placed are calabar bean, belladonna, chloroform, 
quinine and alcoholic stimulants. 

Neuralgia. Neuralgia consists of violent pain in 
the trunk or branches of a nerve, occurring in 
paroxysms, at regular or irregular intervals. It may 
affect any of the sensitive nerves, and the pain 
is generally acute, shooting or darting, with ten¬ 
derness of the part upon pressure. It is sudden 
in its onset and abrupt in its termination. 

Neuralgia is called by different names according 
to its seat. Thus: facial neuralgia is called tic 


Neuralgia . 


'X 

33i 


douloureux; that affecting one side of the head, 
hemicrania; that affecting the sciatic nerve, sci¬ 
atica ; that of the heart, aiigina pectoras; that of 
the stomach, gastrodynia , etc. 

The causes of neuralgia are various and gener¬ 
ally obscure; they may be either local or consti¬ 
tutional. Facial neuralgia often depends upon 
decayed teeth ; when the teeth are properly cared 
for the neuralgia disappears. Local neuralgias 
generally require merely local treatment. Tempo¬ 
rary relief from all forms of neuralgia may be ob¬ 
tained by the use of anodynes, but as long as 
the cause remains, the disease will return. When 
the disease arises from an enfeebled or impover¬ 
ished state of the body, tonics, nourishing diet 
and out-door exercise are to be employed. 


VII.—DISEASES OF THE ORGANS OF RES¬ 
PIRATION AND CIRCULATION. 


Catarrh. The term catarrh is used to denote 
inflammation of the mucous membrane of some 
part of the air passage. It is the most common 
of all diseases. When it affects the mucous 

membrane of the nose it is commonly called “a 
cold in the head ; ” but professionally it is known 
as coryza or nasal catarrh; when the stress of 
the disease falls upon the trachea or bronchial 

tubes it is called bronchial catarrh or bronchitis. 

It arises, not from mere cold, as is commonly 

supposed but from too sudden a change of 
temperature, or from exposure to dampness when 
the body is overheated or exhausted. 

The symptoms of nasal catarrh or cold in the head 
are a sense of uneasiness, heat, and stuffing in 
the nostrils, diminution or loss of smell, dull 
heavy pain in the forehead, inflamed eyes and 
sneezing. A fluid is discharged from the nostrils 
which at first is thin and acrid, but which after¬ 
wards becomes thick and ofteh purulent. Attacks 
of catarrh are apt to recur on slight causes in 

susceptible persons; these repeated and long-con- 

33 2 


Catarrh . 


333 


tinued attacks of the disease cause chronic inflam¬ 
mation of the nostrils, which is professionally 
called ozaena, or rhinorrhoea. The mucous mem¬ 
brane becomes thickened and impedes the pas¬ 
sage of air, causing great uneasiness or “stuffi¬ 
ness ; ” but the most troublesome symptom con¬ 
sists of a profuse discharge which is often quite 
purulent and tinged with blood, and. frequently is 
the cause of persistent hawking, spitting and 
gagging. Large solid flakes of hardened mucous 
frequently come away ; the smell from which, owing to 
the rapidity with which they decompose, is often 
so horribly offensive, and taints the breath to such 
an extent, that the patient is an object of disgust 
to both himself and friends. As the disease pro¬ 
gresses the sufferer gets miserable, despondent, 
passes restless nights, his appetite diminishes, his 
strength fails, and he loses flesh. The septum of 
the nose often gets eaten through in severe cases, 
especially when the system is tainted with the 
poison of syphilis. Fortunately, in most cases, 
the disease appears in a mild form, or just severe 
enough to be a source of annoyance. 

Probably every one in this climate has suffered 
from a common cold at some time or other, and 
thousands at the present time are suffering from 

•t 

chronic inflammation of the nostrils. People gen¬ 
erally suppose the disease to be incurable ; there¬ 
fore they make the best of their misfortune, and 


/ 


334 Diseases of the Organs of Respiration. 

perhaps experiment on themselves occasionally by 
taking quack medicines. Catarrh, however, is cur¬ 
able ; but the means used should be adapted to 
each particular case. What will cure it in one 
person may aggravate it in another. Judgment 
and experience are required in the selection of 
remedies. When catarrh is neglected or improp¬ 
erly treated, it may continue indefinitely. The 
treatment in most cases must be both local and 
constitutional. The first hour or two after a cold 
is taken it may be readily cured by anything 
that restores the warmth and equalizes the circu¬ 
lation. When we have taken cold by getting the 
feet wet, we should promptly bathe them in hot 
mustard water, and use hot drinks to open the 
pores of the skin that have been closed by the 
chill. Alcoholic drinks or hot tea made of herbs, 
when judiciously employed in the early stages of 
catarrh, are useful in equalizing the circulation, 
restoring the function of the skin, and relieving 
chilly feelings. Herb tea is recommended as pref¬ 
erable to the alcoholic drinks for general use, for 
the patient is apt to find the latter so exceed¬ 
ingly efficacious that he may imagine that he has 
found a grand panacea for all his afflictions, and 
be lured on to excess and drunkenness. 

A hot air or vapor bath and a ten-grain Dover’s 
powder taken at bedtime, with a mild aperient in 
the morning, will also cut short a catarrh in its 


Bronchitis. 


335 


early stages. Another remedy is the inhalation 
of iodine vapor every three or four minutes for 
an hour; each inhalation lasting one minute and 
being accomplished by merely holding in the warm 
hands a bottle of the tincture under the nose. 

Chronic inflammation of the nostrils requires 
different treatment from that just suggested for the 
acute form of the disease. Attention must be paid 
to the general health, and appropriate medicaments 
applied directly to the diseased parts. Many obsti¬ 
nate cases can be cured with atomized medicated 
fluids; others may require the use of the nasal 
douche, or remedies in the form of powder or 
ointment. Chemically pure drugs should be used; 
distilled water is the best vehicle for solutions. 
Common salt, alum, permanganate potash, tannic 
acid, sulphate zinc, sulphate copper, acetate of lead, 
and chloride zinc are among the remedies used in 
solution with the atomizer and douche. It is best 
to begin with a weak solution, and gradually in¬ 
crease its strength as the case may require. Re¬ 
lief is often obtained by smoking crushed cubeb 
berries and letting the smoke pass out through the 
nostrils ; care must be taken, however, not to go 
out in the cold air immediately after smoking, or 
the disease will be aggravated instead of alleviated. 
Change of residence often does great good in old 
persistent cases. 

Bronchitis . Inflammation of the mucous mem- 


336 Diseases of the Organs of Respiration. 

brane of the bronchial tubes is called bronchitis ; 
it is the most common of the pulmonary diseases 
and prevails most frequently during the spring 
months. It is caused by a sudden change of 
temperature, or by exposure to a cold, moist 
atmosphere when over-heated, tired, exhausted or 
debilitated. 

Its first symptoms are those of a common cold, 
accompanied with an occasional cough and a sense 
of weariness and headache. There is more or less 
fever, a sense of tightness or constriction about 
the chest, and hurried respiration with wheezing; 
and the cough which at first is short, dry and 
tight, afterwards becomes deeper and looser, with 
expectoration; the latter being at first a viscid 
glairy mucous, but subsequently becomes purulent. 

Bronchitis may be acute Qr chronic; the latter 
is the result of the former, and is generally met 
with among weakly persons and old people. It 
differs from the former merely in the mildness of 
its symptoms and its longer duration. Bronchitis 
has a tendency to recur again and again, but it 
is seldom fatal in vigorous middle life; it often 
assumes a very dangerous character, however, when 
it occurs in the young, aged and feeble. Deep 
inspirations, or breathing cold air, excites acts of 
coughing which occur in paroxysms, and consist 
of a deep inspiration followed by a series of ex 
piratory efforts. In severe cases, the symptoms 


Bronchitis. 


337 


become more and more alarming; the breath be¬ 
comes difficult from the clogging of the tubes 
with mucous, and when at last the patient is so 
exhausted that he ceases to expectorate, he dies 
of suffocation from the accumulated • mucous; 
death usually occurring between the sixth and 
tenth days of the attack. With favorable cases 
the disease begins to decline between the fourth 
and eighth day, and soon entirely subsides or 
passes into the chronic form. 

Bronchitis can frequently be cut short within 
the first twenty-four hours, by taking at bedtime 
a hot mustard foot bath, a glass or two of hot 
lemonade, a ten-grain Dover’s powder, and apply¬ 
ing a mustard poultice to the chest. In many 
cases the writer prescribes instead of the Dover’s 
powder a powder composed as follows : 

7 -> Opii pulv., Ipecac pulv., of each, one grain, Potass, nit. pulv. four 
^ grains , Camph. pulv. Rad. Glycyrrhiza pulv., of each, two grains. 

Mix, and take at one dose. Children should 
be given a smaller dose in proportion to their 
age. 

Should the abortive treatment fail or be omitted, 
a brisk purgative and warm diluent drinks should 
be prescribed; and then perhaps a saline mixture 
containing ipecac and squills will be useful; or 
if there be any depression, a stimulating expecto¬ 
rant should be ordered. Inhalation of the steam 


338 Diseases of the Organs of Respiration. 

of tar water, or of the steam from an infusion of 
hops, often soothes the air tubes advantageously. 
If the cough be very violent, persistent, or fre¬ 
quent, it can be relieved by taking the above 
prescription in five-grain doses, repeated when 
required. Should phlegm accumulate in the bron¬ 
chial tubes, an emetic will remove it. If there 
is much debility, the system must be sustained 
by nourishing food, tonics and stimulants. 

Chronic bronchitis requires the persevering use 
of counter-irritation over the chest, and the use 
of stimulating, alternated with alterative expectorants 
and tonics. Quinine, iron, and cod liver oil are 
valuable when the system is below par. Atom¬ 
ized medicated fluids give marked relief in many 
''ases. The patient must guard against everything 
tending to aggravate his disease. Persistent cases 
are often benefited by a change of residence. 

Pleurisy. Inflammation of the pleura, or invest¬ 
ing membrane of the lungs, is called pleuritis or 
pleurisy. It is most prevalent in winter, and next 
to that in autumn. It occurs most frequently in 
the weak, debilitated, and aged, and its most 
common cause is exposure to cold and wet when 
overheated, tired or exhausted. 

Pleurisy usually commences with chills or 
slight rigors, followed by fever and an acute 
lancinating pain directly below the nipple. The 
pain is commonly called “a stitch in the side,” 


Pleurisy . 


339 


and it is increased by a long breath, by cough¬ 
ing, and by pressure. There is usually a short, 
harsh cough, hot dry skin, and the breathing is 
frequent, short and anxious. In the great major¬ 
ity of cases the disease effects only one side. 
Physicians who have had experience in determin¬ 
ing the meaning of the sounds produced within 
the chest, rely more upon the ear than upon 
the appearance of the patient in diagnosing dis¬ 
eases of the organs within this cavity. When 
we listen to the painful part of the chest in 
the early stage of pleurisy, we hear the dry 
inflamed membranes rubbing against each other, 
producing a friction sound; but as the disease 
progresses the sound ceases. The inflammation 
either terminates in resolution and the two sur¬ 
faces of the pleura regain their natural moisture 
and smoothness; or, the inflamed and roughened 
surfaces becomes adherent; or, they become sep¬ 
arated by the effusion of serum, and a form of 
dropsy known as hydrothorax, results. 

In the early stage of pleurisy the pain pre¬ 
vents the sufferer from lying on the diseased 
side, therefore he lies on his sound side or back; 
but after effusion has occurred the weight of 
the liquid would impede the motion of the healthy 
lung if the patient lie upon that side, and as 
the pain is now diminished, he lies on his dis¬ 
eased side or back. 


340 Diseases of the Organs of Respiration . 

In mild cases, or when proper treatment has 
been adopted at the beginning of the attack, 
only a small quantity of liquid is effused into 
the chest, and recovery takes place within a 
week. The quantity of liquid may vary from a 
very few ounces to several pints, and when the 
accumulation is considerable the disease may 
continue from one to three months. If the pleura 
be full of fluid there will be dullness on percus¬ 
sion all over the affected side; but if it be 
only partly filled, we can judge of the quantity 
by placing the patient in different attitudes, as 
the fluid will gravitate to the most dependent 
part and carry the dull sound with it. Although 
the pain is greatly diminished after effusion has 
occurred, there is increased difficulty in breath¬ 
ing ; this is most urgent when the quantity of 
effused liquid is considerable and the lung mostly 
compressed. 

Pleurisy is rarely fatal in young and vigorous 
persons; but when it is met with in children, 
the aged or debilitated, it may lead to serious 
results. 

In the treatment of pleurisy, the first object 
is to subdue the local inflammation and prevent 
effusion. To accomplish this result the sufferer 
should be kept very quiet in bed, the bowels 
kept open, and diaphoretics administered. A 
large, hot, moist, linseed poultice, covered with 


Pneumonia. 


341 


the extracts of poppies and belladonna, and 
applied to the affected side, will probably give 
greater relief than any other local remedy. In 
some cases the use of opium, given sufficiently 
to relieve pain and tranquilize the system, is 
advisable. Cooling drinks may be taken freely. 
When the patient is plethoric and pain very 
severe, the removal of three or four ounces of 
blood by unloading the congested vessels, often 
gives relief; blood letting, however, should not 
be resorted to indiscriminately. 

When the abortive treatment has been neg¬ 
lected or failed, and effusion has occurred, we 
must endeavor to promote absorption. A moder¬ 
ate diet free from stimulants, and the judicious 
use of iodide of potassium, purgatives and diu¬ 
retics are recommended. The action of the 
absorbents may be increased by the application 
of mustard drafts to the diseased side. The 
quantity of fluids taken into the system should 
be as small as is compatible with comfort; if 

st 

they are taken into the system abundantly the 
elimination of water is of little or no avail. 

Pneumonia . • Inflammation of the substance of 
the lungs is called pneumonitis or pneumonia. 
It occurs most frequently in the winter and 
spring months; it may attack persons of all ages, 
and its average duration is about ten days. 

The ordinary exciting cause of pneumonia is 


342 Diseases of the Organs of Respiration. 

exposure to cold and dampness; but latent 
tubercle, and the previous state of the health, may 
predispose to it. The disease may affect one lung 
or both, or, technically speaking, may be double 
or single. The right lung suffers from inflamma¬ 
tion twice as often as the left; about once in 
eight cases both are affected. 

Pneumonia is characterized by fever, high tem¬ 
perature, dull pain (not always present) in the 
chest, accelerated and oppressed breathing, cough, 
occasional delirium, and expectoration by the fourth 
day of a viscous, rust-colored sputa. The height of 
the attack is generally reached between the fifth 
and seventh days; after which the temperature 
declines, and in favorable cases all the symptoms 
subside. In unfavorable cases the symptoms become 
more and more aggravated, until at last the patient 
dies exhausted or asphyxiated. A high degree of 
fever attended with delirium, great oppression in 
breathing, prostration, acute pain and dry cough 
denote great danger. In fatal cases death seldom 
occurs before the sixth, and may be as late as 
the twentieth day. 

The first day of an attack of pneumonia, a 
saline purgative should be administered, followed by 
sedatives, as aconite or opium in small doses. A 
hot, moist linseed poultice, with a little oil 
smeared over its surface, may be applied to the 
chest; but in cases where counter-irritation is 


Phthisis or Consumption. 


343 


desired, tincture of iodine or a mustard plaster may 
be applied. The powder recommended in bronchitis 
may be taken when the cough is troublesome. 
Pneumonia belongs to that class of diseases known 
as self-limited. If uncomplicated, and not attended 
by accidents, it runs a definite career, ending in 
restoration, provided the powers of life hold out ; 
therefore the leading, general indication in the 
second stage of the disease is to support the 
powers of life. The supporting treatment embraces 
a nutritious diet, tonic remedies, and alcoholic 
stimulants. 

Phthisis or Consumption. Phthisis, or pulmonary 
consumption, is a disease which leads to ulceration 
and destruction of the lung tissue. Persons of all 
ages, and both sexes, are liable to its attack, which 
at first is usually so insidious as almost to escape 
notice. Phthisis is generally caused by the deposit 
of scrofulous matter in the substance of the 
lungs. The deposit takes place in the form of 
small, gray, semi-transparent granules, called 
tubercles, which gradually enlarge, become opaque, 
and at length soften and acquire the consistence 
and appearance of pus, or matter; they communicate 
with each other, and gradually destroy the sub¬ 
stance of the lungs, and empty into the bronchial 
tubes or air passages, and pass off by expectora¬ 
tion. 

The predisposing causes of phthisis are hereditary 


3 /)/) Diseases of the Organs of Respiration. 

tendency, sedentary employments, exhausting ex¬ 
cesses and bad hygienic conditions. The exciting 
cause is often an attack of bronchitis, or pneu¬ 
monia, or some eruptive fever, or inhaling irrita¬ 
ting substances, as dust, fine particles of metal, 
coal, stone, etc. Inhalation of irritating sub¬ 
stances is incidental to certain occupations. 

The earliest symptom of phthisis or consumption 
that usually manifests itself, is a slight, dry, hacking 
cough, exciting but little or no attention, or per¬ 
haps attributed to a slight cold. After an indefinite 
period expectoration, at first small, and consisting 
of foamy or glairy mucous occurs. The cough 
gradually becomes more frequent, and is par¬ 
ticularly troublesome during the night; the expec¬ 
toration progressively increases, becoming more or 
less abundant, viscid and opaque. Spitting of 
blood, or slight hemorrhage from the lungs, fre¬ 
quently takes place shortly after the occurrence 
of cough and expectoration. In some cases it 
precedes these symptoms, and it is usually the 
event which first excites uneasiness in the mind 
of the patient. As the disease advances, the 
breathing and pulse become more hurried, and the 
patient becomes languid, indolent, and gradually 
loses strength. Weakness of the voice, or hoarse¬ 
ness, is not uncommon. Towards evening there 
is frequently experienced a slight degree of chil¬ 
liness, followed by slight fever and nocturnal 


Phthisis or Consumption. 


345 


perspirations. The cheeks may occasionally present 
a circumscribed flush, and the palms of the hands, 
and the soles of the feet, may at times be 

affected with a burning heat. The patient becomes 
emaciated, weakness increases, and a pain is felt 
in some part of the chest, which is increased by 
coughing, and may become so acute as to prevent 
the sufferer from lying on the affected side. 
The feet and ankles begin to swell, and in 
the last stage of the disease there is nearly 

always profuse diarrhoea. The countenance now 
assumes a cadaverous appearance; the cheeks are 
hollow, the bones prominent, the eyes sunken, 
the nose sharpened and drawn, the lips retracted 
so as to produce a bitter smile, the hair thinned 
by falling out, and the emaciation can be almost 
seen to advance daily. Cases differ in regard to 
the desire for food, and the ability to digest 

9 

it; but as a rule, the appetite and digestion are 
more or less impaired. The intellect usually 
remains bright and active, and the feelings are 
usually cheerful and buoyant, notwithstanding the 
progress of the disease. Patients often take 
offence at an intimation that they are consump¬ 
tive, and even when informed by a competent 

physician, generally think him mistaken. They 
are hopeful respecting their condition, and are 
easily persuaded that they are improving; there¬ 
fore they fall an easy prey to quacks. 


346 Diseases of the Organs of Respiration . 

The duration of phthisis or consumption depends 
upon a great variety of circumstances, and varies 
from a few months to several years ; the average 
duration being about two years. The disease is 
known as “ quick consumption” when it runs a 
rapid course, passing through its changes and 
destroying life in a few weeks or months. 

Consumption can often be contracted by inhaling 
the breath of those afflicted with the disease; 
therefore no one should be allowed to sleep with 
a consumptive patient. In the earliest stages of 
the disease its further development may in certain 
cases be prevented by skilful treatment ; but 
after the disease has been neglected and allowed 
to become fully established, little except palliation 
can be effected. 

The most important part of the treatment is 
hygienic. The progress of consumption may fre¬ 
quently be suspended by change of residence, diet, 
habits and occupation. The prevalence of the 
disease is less in climates either uniformly warm 
and dry, or uniformly cold and dry, than in those 
which are moist and subject to frequent alterna¬ 
tions of cold and warmth. 

The diet of consumptives should be generous 
as regards quantity, quality and variety ; the appe¬ 
tite should be encouraged, as the object is to 
nourish the body to the fullest possible extent. 
Exercise in the open air, or an out-of-door life, is 


Asthma. 


347 


of paramount importance. The body should be 
properly protected against atmospherical changes, 
and the mind pleasantly occupied. 

The two medicines which have been found 
most useful in the treatment of this disease are 
cod liver oil and alcoholic stimulants; the former 
is frequently administered in connection with the 
hypophosphites ; but a formula frequently prescribed 
with good success by the writer is as follows: 

Cod Liver oil; Bourbon whiskey (best quality); of each , one half 
pint. Tinct. of Iodine , three fluid drachms. 

Mix, and take one tablespoonful after each meal. 
Always shake the bottle before the medicine is 
poured out. 

The complications of consumption should be 
treated as they arise. Excessive coughing may 
be relieved by small doses of morphia; hemorrhage 
from the lungs, by fluid extract ergot; night sweats, 
by aromatic sulphuric acid (see “Sage Tea”); 
and the diarrhoea by astringents and opiates. 

Asthma. Contraction of the circular fibres of 
the bronchial tubes by obstructing the passage of 
air, causes difficulty in breathing, accompanied by 
a wheezing noise and a feeling of tightness across 
the chest; this condition is called asthma. 

The attack occurs in paroxysms usually about 
three or four o’clock in the morning. The 
patient is suddenly awakened from sleep, gasping 


348 Diseases of the Organs of Respiration. 

for breath, and is obliged to assume an upright 
posture to prevent suffocation. The pulse is small 
and feeble, the eyes staring, the countenance anx¬ 
ious, the skin cold and clammy, and the patient 
is in such distress that he perhaps thinks he is 
about to die. The disease is rarely fatal, however, 
and the symptoms usually subside in two or three 
hours. 

The disorder is called humid or’humoral asthma 
when the attack ceases with expectoration, and 
dry asthma when without it; both forms are often 
connected with an affection of the respiratory 
organs and with disease of the heart. When 
the attacks are merely nervous, the patient enjoys 
moderately good health during the interval that 
elapses between one asthmatic paroxysm and the 
next. 

Asthma afflicts men more frequently than women ; 
is hereditary in the majority of cases, and may 
occur at any age, though most common about the 
middle period of life. The objects of treatment 
during an asthmatic paroxysm are to lessen the 
suffering and bring the paroxysm to an end as 
speedily as possible. To accomplish these results 
anti-spasmodic medicines and gentle aperients are 
required. 

There are various anti-spasmodic medicines, each 
of which proves efficacious in some cases, but not 
in others. Wine of ipecac and tincture of lobelia, 


Croup. 


349 


mixed in equal proportions, and taken in half¬ 
teaspoonful doses every twenty or thirty minutes 
until nausea and expectoration occurs, is an old 
remedy ; it is valuable in some cases, but useless 
in others. 

Smoking stramonium leaves, or inhaling the 
smoke of burning bibulous paper which has been 
soaked in a saturated solution of saltpetre, acts 
like a charm on many persons when afflicted 
with the disease; and often inhaling the vapor 
of chloroform or ether will relax the spasm, the 
patient passing from a condition of great suffer¬ 
ing to one of ease and comfort in a few moments; 
but care is required in the use of chloroform and 
ether, and they should be administered only by a 
competent physician. Compound spirits of ether, 
tincture of henbane, hydrate of chloral, and hot 
mustard foot baths, all have their value when 
properly used. 

To prevent the return of a paroxysm, the ner¬ 
vous system should be invigorated, the general 
health improved and the exciting causes of the 
disease avoided. The emanations from hay, feathers, 
etc. excite paroxysms of the disease in certain 
persons, who of course should avoid exposure to 
these causes. 

Croup. Croup is an acute inflammatory disease 
of the trachea, or often of the glottis larnyx and 
trachea, which generally occurs in children between 


350 Diseases of the Organs of Respiration. 

the ages of one and seven years. It occurs most 
frequently in cold, damp, changeable climates, and 
is one of the most dreaded and fatal diseases 
with which children are afflicted. 

There are two kinds of croup ; true and false. 
True croup comes on gradually, and is less likely 
to excite alarm than false croup which comes on 
suddenly. True croup is accompanied by fever, 
and the exudation of false membranes upon the 
affected mucous surfaces. False croup—spasmodic 
closure of the glottis, causing shrill breathing — 
is not accompanied by fever or the exudation of 
false membranes. It is rare for true croup to 
recur in the same individual; false croup is apt 
to recur again and again. The average duration 
of true croup is from two to five days; false 
croup lasts only a few moments or few hours. 
About half of the cases of true croup end fatally; 
false croup seldom ends fatally, and those not 
familiar with the disease are often astonished to 
find the next morning the little sufferer of the 
night before playing about as lively as ever. 

Genuine croup is not as common an affection 
as is generally supposed. The majority of the 
cases of so-called croup are nothing more than 
spasm of the glottis or false croup. Relaxation 
and secretion are the two great desiderata in the 
treatment of either true or false croup, and more 
depends on early treatment than in any other 


Whooping Cough. 


351 


disease. Emetics and anti-spasmodics, as ipecac, 
alum or lobelia, when judiciously used, and espe¬ 
cially when aided by a hot foot bath, give relief 
in most cases. The child must be kept in a 
warm room, and in true croup, the inhalation of 
steam from water poured upon unslacked lime, 
and hot fomentations to the throat, often does 
much good. A saline purgative may be given if 
required. The strength of the patient must be 
sustained by a nourishing diet, and when neces¬ 
sary, the cautious use of stimulants. Cases in 
which medicines fail to remove the obstruction 
from the upper part of the air-passage, physicians 
sometimes save life by performing an operation 
called tracheotomy, which consists of cutting into 
the trachea for the purpose of admitting air into 
the lungs ; a small silver tube is introduced into 
the opening made, through which the patient 
breathes. 

Whooping cough. Whooping cough, like croup, is 
especially a disease of childhood. It is infectious, 
and after an incubation of about six days, it 
commences with symptoms resembling those of 
acute bronchitis. A peculiar, hard, convulsive 
cough soon appears; it occurs in paroxysms at 
uncertain intervals ; it consists of a rapid succes¬ 
sion of short, but violent, expiratory efforts, and 
there is scarcely any interval of inspiration ; the 
air is so largely expelled from the lungs that 


352 Diseases of the Organs of Respiration. 

the patient seems on the point of being suffo¬ 
cated when the air is taken in by force through 
the contracted glottis, causing the characteristic 
whooping noise. The paroxysms of coughing end 
in expectoration of a ropy gelatinous phlegm, like 
albumen, or often in vomiting, or sometimes in 
complete exhaustion. The child generally appears 
well and plays about in the intervals between one 
fit of coughing and the next. 

The duration of whooping cough varies from 
three weeks to several months, but it is rare 
for it to recur in the same individual. Compli¬ 
cations, as bronchitis, pneumonia, etc., sometimes 
occur. The disease is most ^dangerous in the 
youngest children; it is more serious when epi¬ 
demic and when it attacks an unhealthy child. 
Those afflicted with the disease should avoid 
sudden changes in temperature and exposure to 
dampness. 

“ Hygienic measures form an important part of 
the treatment. If there be no complications 
which interfere with exposure to the open air, 
this should by all means be advised and enforced. 
Under proper prudential restrictions, the more 
out-of-door life the better. The diet should be 
nutritious. If from the frequency of vomiting 
the system suffer from innutrition, alimentation 
becomes an important object of treatment. The 
patient should take food as often and as soon 


Diphtheria. 


353 


after a paroxysm as possible .”—Flints Practice 
Medicine , 3 d ed. p. 237. 

Various medicines have been used and recom¬ 
mended in the treatment of this disease. Those 
upon which the most reliance can be placed are 
ipecac, belladonna, hydrate chloral, bromide potash, 
morphia, lobelia and chestnut-leaves, all of which 
when properly used are doubtless more or less 
curative in a certain proportion of cases. An 
infusion or fluid extract of chestnut-leaves it is 
said will control the paroxysms in a remarkable 
manner, and in some cases suspending them 
entirely after the lapse of.p few days. 

Diphtheria. Diphtheria is an acute, specific, infec¬ 
tious and contagious disease, characterized by a 
spreading, asthenic inflation of the mucous mem- 
brane of the throat and the exudation of false 
membranes on the tonsils and adjacent parts. 

It usually occurs epidemically; it is very rare 
in old age, and is not frequent among adults; 
it attacks chiefly children. It may recur in 
those who have once had it, and some individu¬ 
als and families have a greater predisposition to 
it than others. 

After the period of incubation, which gener¬ 
ally is from two to five days, the symptoms of 
diphtheria commence very gradually with feelings 
of depression, muscular weakness, headache, furred 
tongue, nausea, slight fever and painful degluti- 


354 Diseases of the Organs of Respiration. 

tion. The tonsils become swollen and dark col¬ 
ored, and the glands about the angles of the 
lower jaw get tender. The false membrane first 
appears in the form of white or gray spots on 
the tonsils or pharynx; these spots by their 
enlargement and coalescence form patches of 
considerable size, which gradually extend forward 
to the soft palate and into the nostrils, or back¬ 
ward into the esophagus or larynx. The false 
membrane increases in thickness as the disease 
spreads; and although at first it is of a white 
or gray color, it soon becomes brown or almost 
black, and of an offensive odor. If it be forcibly 
removed the surface' beneath is seen to be red 
and bleeding, and in a few hours becomes cov¬ 
ered with a fresh layer. The tonsils may sup¬ 
purate or even slough, and when the nostrils 
become involved and lined with false membrane, 
they become swollen and emit an acrid and fetid 
discharge. Hemorrhage frequently occurs; there 
is usually, also, a low and dangerous form of 
fever, with great depression of spirits and rapid 
decrease of the patient’s strength, which is still 
further accelerated by his inability to take food. 
The duration of the disease in favorable cases is 
from ten to fifteen days. Termination in death 
or in recovery generally becomes apparent in 
seven days. Membranes must not be torn off, 
neither must they be removed until they become 


Diphtheria. 


355 


partly loosened; then an emetic will remove them. 

Diphtheria varies greatly in its general characters. 
That form of the disease just described is known 
as the malignant variety which ends fatally in 
the majority of cases. It does not always appear 
in this severe form. Frequently the general and 
local symptoms are trifling, attended with but 
little fever, but little soreness of the throat, but 
slight difficulty in swallowing, and no nervous 
symptoms. The disease is then known as the 
simple variety; it is not very dangerous to life. 

That form of the disease known as the croupous 
variety, which often follows measles or scarlet 
fever so closely as to seem one of their latter 
stages, is very fatal. 

Various modes of treating diphtheria have been 
recommended, but it is impossible to lay down 
a routine treatment appropriate to all cases. The 
hygienic management of the case — cleanliness, 
ventilation and disinfectants should receive first 
attention. The nourishment of the patient is a 
matter of very great importance, and the strength 
is to be supported by means of tonics and stim¬ 
ulants. The remedies employed should be admin¬ 
istered as early as possible, in suitable doses and 
at proper intervals. The treatment is frequently 
of no service, because it has been commenced too 
late. When the patient is unable to swallow, 
remedies may be administered by enema, qr 


356 Diseases of the Organs of Respiration. 

hypodermically ; the local treatment is also import¬ 
ant. High fever should be reduced by sponging 
and baths. Of the various medicines used, inter¬ 
nally and locally, chlorate potash, tincture chloride 
of iron, carbolic acid and alcoholic stimulants are 
the most important. 

Diseases of the Heart. The heart is subject to 
two classes of diseases; viz. : functional or nervous, 
and structural or organic. The former is merely 
a disturbance of the heart’s action, caused by 
sympathy of reflex action ; but the latter is con¬ 
nected with actual morbid changes in the heart’s 
structure. 

To determine whether a person is suffering from 
disease of the heart, and whether the disease be 
functional or structural, we rely chiefly upon 
auscultation and percussion, or what is commonly 
known as “sounding the chest.” The heart being 
excluded from vision, but little knowledge of its 
condition can be obtained by inspection; there¬ 
fore the ear is the only reliable means of de¬ 
tecting the existence of its various diseases. The 
heart gives out two sounds, which have been 
compared to the two syllables lupp, dupp; any 
manifest alteration in these sounds is indicative 
of the existence of disease; they may be high 
or low, clear or dull, muffled, rough, intermittent, 
etc. Murmurs or regurgitant sounds may arise 
from disease of the valves. The power of distin- 


Diseases of the Heart. 


35 7 


guishing between the normal and abnormal sounds 
of the heart, and of the causes producing the 
latter, can only be obtained by prolonged expe¬ 
rience ; therefore those who wish reliable infor¬ 
mation as to whether their heart is healthy or 
diseased should consult some skilful and honora¬ 
ble physician who is practised in the arts of aus¬ 
cultation and percussion. 

Chief among the functional diseases of the 
heart are palpitations, syncope or fainting, and 
angina pectoris. They are chiefly met with in 
persons of a nervous temperament, and may be 
induced by excessive mental excitement, dyspepsia, 
or general nervous debility. The exciting cause of 
the disorder should be removed, if possible, and 
the general health improved by means of tonics, 
sea-bathing, and moderate exercise in the open 
air. 

Chief among the structural diseases of the heart 
are pericarditis, endocarditis, fatty degeneration, 
hypertrophy, dilatation and disease of the valves. 
Pericarditis, or inflammation of the membrane 
covering the heart, may be induced by exposure 
to cold and dampness, and is a frequent attend¬ 
ant of acute rheumatism. Endocarditis, or inflam¬ 
mation of the lining membrane of the cavities of 
the heart, may be induced by the same causes. 
Fatty degeneration of the heart, the substitution 
of fatty substance for muscular tissue, may be 


35 8 Diseases of the Organs of Respiration . 

induced by any exhausting • or depressing cause. 
Confirmed drunkards are apt to have fatty degen¬ 
eration of the heart, as it may be caused by 
the excessive and prolonged use of alcoholic 
liquors. Hypertrophy, or enlargement of the heart, 
may be induced by valvular obstruction, regurgi¬ 
tation compelling unusual and continued effort to 
sustain the circulation. Dilatation of the heart 
is when one or more of the cavities are enlarged 
in size without the substance of the heart itself 
being increased. It may depend on a debilitated 
state of the heart’s muscular tissue, or on valvu¬ 
lar disease, or on obstruction beginning in organs 
remote from the heart. The valves of the heart 
are subject to a variety of diseases which inter¬ 
fere with their proper action. 

Those afflicted with heart disease in any of its 
forms should avoid excitement, anxiety and rapid 
or excessive exercise. Violent effort or emotional 
excitement may be suddenly fatal. The medicines 
used will depend upon the particular symptoms 
presented. 


VIII. — DISEASES OF THE ALIMENTARY 

CANAL. 


Mumps. Mumps, or parotitis, is an acute, con¬ 
tagious, specific inflammation of one or both par¬ 
otid glands. It generally occurs but once in a 
lifetime, and most frequently in children about five 
years of age. 

It commences with slight feverish * symptoms 
and swelling about the angle of the jaw; the 
parts in the immediate vicinity of the parotid 
gland soon becoming hot, painful, and tender to 
the touch. There is pain in mastication, deglu- 
tion and articulation. The disease reaches its 
height in four days, and then declines and grad¬ 
ually disappears. 

As mumps is generally a mild affection, it 
requires but little treatment. The patient should 
avoid sudden changes in temperature, cold and 
dampness. A mild laxative may be taken, if 
required, and a warm flaxseed meal poultice may 
be applied to the swollen parts; but in most 
cases no local application is necessary. 

Tonsilitis or Quinsy. Inflammation of the ton¬ 
sils, tonsilitis or quinsy, commences with chilli- 

359 


360 Diseases of the Alimentary Canal. 

ness, followed by feverishness, a flushed face and 
a husky voice. The tonsils soon become inflamed, 
swollen, painful, and great difficulty is experi¬ 
enced in swallowing — liquids sometimes returning 
through the nostrils. 

The disease is caused by exposure to cold and 
wet, or sudden changes in temperature, and 
under ordinary circumstances the inflammation 
runs an even course, and terminates favorably in 
a few days; the tonsils, however, are left tem¬ 
porarily swollen or permanently enlarged. When 
the inflammation is very severe and prolonged, 
the pain is very constant and throbbing, and the 
morbid action frequently leads to suppuration in 
one or both of the glands. 

In the treatment of tonsilitis the bowels should 
be kept gently open ; flaxseed lemonade freely 
used as a drink; hot fomentations or linseed 
poultices applied to the throat; and a solution of 
chlorate of potash used as a gargle. Should the 
enlargement of the tonsils become chronic, they 
should be painted daily with tincture of iodine, 
and the syrup of iodide of iron may be admin¬ 
istered internally. 

Dyspepsia. Dyspepsia means literally difficult 
digestion. Its chief symptoms are a sense of 
fulness, weight and uneasiness at the stomach, 
especially after taking food, eructations, heart¬ 
burn, nausea, foul tongue, bad taste in the 


Dyspepsia. 


361 


mouth, headache, palpitation, restless nights, tired 
feeling on waking, drowsiness, irregular bowels and 
loss of appetite, or capricious appetite, with par¬ 
ticular aversion to fat or oily substances, and 
sweet or insipid articles of diet. These symptoms, 
however, vary greatly in their severity; one indi¬ 
vidual suffering severely when his food “disagrees” 
with him, while another has merely slight depression. 
One of the worst of the occasional concomitants of 
dyspepsia is that state of mind which is known 
as hypochondriasis. There is languor, listlessness, 
gloomy forebodings, want of resolution, and an 
apprehension of some great evil in the future. 

1 

Dyspepsia may be caused by anything which 
interferes with the healthy action of the stomach 
and intestines. Its most frequent causes are over¬ 
loading the stomach, especially with improper food, 
or when followed by violent exercise, imperfect 
mastication and hurry in eating, great anxiety or 
emotional excitement immediately after meals, 
excessive use of alcoholic liquors, opium, tobacco, 
coffee, or medicine out of place, and sedentary 
habits. 

In the treatment of dyspepsia it is of the 
utmost importance that those habits which have 
generated the disorder should be discontinued. 
The quality of the food should be attended to, 
and the quantity of it introduced into the stomach 
should be kept within the limits of its capacities 


362 Diseases of the Alimentary Canal. 

and powers. The proper regulation of the diet 
alone will often effect a cure. (See Digestion, 
and Facts and Fallacies Concerning Eating and 
Drinking. ) 

The use of medicines, although of secondary 
importance, is often useful and absolutely essen¬ 
tial. Perhaps the most valuable is pepsine, the 
digestive principle of the gastric juice. It should be 
taken at meal time in doses proportioned to the 
necessity of the case. In some instances, where 
pepsine alone fails, the troublesome symptoms 
may be relieved by the simultaneous use of a 
small quantity of the dilute hydrochloric acid, or 
about the one seventh of a grain of the hydrochloric 
of morphia, or when great atomy prevails, the one 
twenty-fourth of a grain of strychnia. There are 
other medicines, such as nitro-hydrochloric acid, 
rhubarb and ginger, which increase the gastric 
secretion; the first, when given in small doses 
well diluted, is often especially useful. If you 
wish to restrain undue secretion, moderate doses 
of aromatic sulphuric acid, bismuth, conium or 
opium may be administered; but if 'there be an 
excessive secretion of acid, alkalies are needed. 

Wine and well-diluted spirits are often very 
beneficial to the dyspeptic, provided that they be 
taken in strict moderation and only at meal-time. 
There is considerable “ wear and tear ” in wag¬ 
ing the battle of life, and the digestive organs 


Diarrhoea. 


363 


are the first to sympathize with the terrible anx¬ 
ieties, intense disappointments or depressions of 
the mind, as well as with the fatigues of the 
body; therefore the precept furnished by St. Paul 
to Timothy— . . . “Use a little wine for thy 
stomach’s sake and thine often infirmities”—may 
be adopted with advantage by many persons. 
Care must be taken, however, to avoid taking 

too much. It should be remembered that the 

* 

effect of alcoholic drinks on most persons, is 

such that it is easier for them not to drink at 

all than it is to use the spirits moderately; there¬ 
fore, perhaps on the whole, it is best to abstain 
from their use entirely. 

Diarrhoea. Diarrhoea is a disease characterized 
by more frequent and thinner evacuations from 
the bowels than natural. It is more apt to occur 
during the summer and autumn months than at 

any other period of the year; and it may be 

occasioned by anything that stimulates or irritates 
the mucous surface of any portion of the alimen¬ 
tary canal. The most frequent cause of the dis¬ 
ease is error in diet. It is also a symptom of 
many different diseases. 

The symptoms of diarrhoea, in addition to purg¬ 
ing, are nausea, furred tongue, foul breath, flatu¬ 
lence, acid eructations, griping pains, and, if the 
disease is not checked, great emaciation. 

Children are more subject to diarrhoea than 


364 Diseases of the Alimentary Canal. 

adults; it is especially prevalent during dentition, 
and it is the most prominent element of the 
affection known as cholera infantum, or summer 
complaint. 

Diarrhoea is one of those diseases by means of 
which nature strives to get rid of impurities and 
restore the system to its normal condition ; there¬ 
fore care must be taken not to check it too 
suddenly. 

The treatment of diarrhoea should vary with the 
cause. When it arises from the presence of some 
offending matter in the intestinal canal, the 
expulsion of such matter must be aided by. 
administering a mild dose of rhubarb or castor 
oil. If the diarrhoea continues after the bowels 
have been freely evacuated, the irritation may be 
subdued by the use of a mild* anodyne, as pare¬ 
goric combined with chalk mixture, or astringents. 
Kino, catechu and krameria are familiar as pure 
astringents. Bicarbonate of soda, with ginger or 
cinnamon, etc., will often relieve the condition of 
the alimentary canal in which diarrhoea originates 
without the use of astringents. Lime water, with 
cinnamon or camphor water, will often correct 
mild cases of diarrhoea in infants. When more 
severe aromatic syrup of rhubarb, either alone or 
combined with paregoric, may be given. The 
diet for a day or two should be simple or some¬ 
what restricted. Vegetables and fruits should be 


Dyseniery. 


365 


avoided. Toast water had better be used as a 
drink in preference to ordinary cold water. 

Dysentery. Dysentery is a disease characterized 
by frequent mucous or bloody stools, attended 
with straining and griping pains in the abdo¬ 
men. 

It is distinguished from diarrhoea by its 
greater severity, the presence of blood in the 
discharges, and in the retention of the natural 
faeces, or in their being expelled from time to 
time in small hard separate lumps. 

Dysentery consists essentially of an inflammation 
of the large intestine, involving the muscular as 
well as the mucous coat. There is fever in most 
acute cases and a tendency to great prostration. 
The disease is very prevalent and fatal in hot 
climates and tropical countries at certain seasons 
of the year. It may be caused by errors in diet, 
foul air, impure water, extreme alternation of heat 
and cold, and exposure to the dews of night, 
particularly after fatigue. 

Severe and protracted cases of dysentery go 
through two stages — the inflammatory and ulcer¬ 
ative. Chronic dysentery differs only in degree 
from the acute form, and arises from the same 
causes, but it presents nearly always ulceration 
of the rectum or colon or both. 

In the treatment of dysentery, perfect rest in 
bed in a well-ventilated apartment, is desirable in 


366 Diseases of the Alimentary Canal. 

all cases. At the commencement of the disorder 
the old practice of administering a dose of castor 
oil with ten or fifteen drops of laudanum is 
advisable; it clears the bowels of irritating sub¬ 
stances ; but when it is neglected and the disease 
has continued a day or two, it had as a rule 
better be omitted; opium may then be adminis¬ 
tered either alone or in combination with ipecac. 
The subnitrate or the subcarbonate of bismuth, 
the acetate of lead and the various vegetable 
astringents are also useful in many cases. The 
diet must be as purely nutritious as possible ; 
the object being to leave but little residuary 
matter, after digestion, to pass into the large intes¬ 
tine. Rice-water, arrowroot, milk, beef-tea, etc., are 
recommended. An infusion of slippery-elm bark 
may be used as a drink to quench thirst. If- the 
symptoms denote failure of the vital powers, con¬ 
centrated nourishment should be given freely with 
such quantity of alcoholic stimulants as may be 
required to rally the vital energies. For chronic 
dysentery the patient must seek relief in a mild, 
dry, equable climate. Tonic remedies may be 
given with advantage during convalescence. 

Cholera. Cholera is generally divided into two 
species ; viz., sporadic cholera, or cholera morbus as 
it is commonly called; and malignant or Asiatic 
cholera. Cholera of either species is most common 
in warm climates ; excessive heat predisposes to it. 


Cholera. 


367 


Cholera morbus apparently arises from an excess 
or acrimony of bile. Warm weather by relaxing 
the mucous membranes and exciting the liver, 
acts as a predisposing or indirect cause of the dis¬ 
ease. The exciting or direct causes may be improper 
food, such as unripe fruits, etc., or sudden changes 
of temperature, or suppressed perspiration. 

An attack of cholera morbus is often abrupt, 
and is ushered in by vomiting and purging, occur¬ 
ring in quick succession and recurring either 
simultaneously or in close alternation. The food 
in the stomach is first discharged ; then a fluid 
varying in color, but always containing bile, is 
thrown up in great abundance; the evacuations 
from the bowels also contain bile. Severe pains 
generally attend the acts of vomiting and purging, 
and in the intervals between the acts the patient 
usually suffers from dryness of the mouth and fauces 
with urgent thirst. There is great anxiety, rest¬ 
lessness and exhaustion, but the disease runs a 
rapid course, and in favorable cases the distress¬ 
ing symptoms gradually subside in the course of 
several hours when properly treated. In more 
severe cases the symptoms acquire a more alarm¬ 
ing character, and may continue two or three days ; 
extreme exhaustion ensues, attended by depression, 
hurried respiration, cold sweats, hiccough, feeble 
pulse, etc. Death may then occur. The vast major¬ 
ity of cases, however, terminate favorably. When 


368 Diseases of the Alimentary Canal. 

this disease occurs in infants it is called cholera 
infantum, or summer complaint. 

In the treatment of cholera morbus, a large 
mustard plaster should be placed over the abdo¬ 
men ; and after it has reddened the skin a spic.e 
poultice, composed of equal parts of ginger, cloves, 
cinnamon and flour moistened with alcohol, may be 
applied. 

There are various “ cholera mixtures ” that are 
quite popular with the general public. Some are 
useful, but the majority of them are useless and 
injurious. Of those that are useful the following 
will perhaps be found best adapted to relieve the 
troublesome symptoms. Take of tincture of ginger, 
opium, capsicum, rhubarb and spirits of camphor, 
equal parts. Mix. Dose from twenty to sixty 
drops in water every half-hour until relieved. Ice 
may be given if the thirst be great. Extreme 
prostration may require the use of brandy inter¬ 
nally. To check the purging when threatening 
collapse a teaspoonful of laudanum mixed with a 
little thin starch should be injected into the 
rectum. Care as regards diet is necessary during 
convalescence. 

Malignant or Asiatic cholera is a term applied 
to a most appalling form of pestilential disease, 
which has carried off millions of human beings. 
Its attack is sudden, often without warning, and 
the patient is frequently a corpse in a few hours. 


Colic . 


369 


Purging and vomiting are the first symptoms. 
The discharge from the bowels is a thin colorless 
fluid, like rice water, and is spurted out with 
spasmodic force. There is great prostration, cold 
clammy sweats, and terrible cramps. The body 
becomes bent, the limbs twisted, the countenance 
cadaverous, the pulse almost imperceptible, the eyes 
sunken and surrounded by a dark circle, and the 
patient sinks into a state of apathy and soon 
expires unless a favorable change speedily takes 
place. 

As regards the treatment of malignant cholera 
the best advice that can be given is to procure 
the services of a competent physician without 
delay; while awaiting his arrival the treatment 
suggested for cholera morbus may be adopted. 

Colic. Colic is characterized by severe griping 
pain and a sense of twisting, especially about the 
navel, occurring in paroxysms. The bowels are 
constipated, and there may be slight nausea and 
vomiting. 

Colic may be caused by indigestion, accompa¬ 
nied with flatulence; or by the presence in the 
bowels of morbid secretions or of retained excre- 
mentitious matter; or by the slow cumulative 
action of mineral poisons such as copper, lead, etc. 
There is also what is called nervous or spasmodic 
colic, which results from fright, cold, hysteria, gout, 


etc. 


370 Diseases of the Alimentary Canal. 

The treatment of colic will in each case depend 
very much upon the cause. In most cases the first 
object is to procure an evacuation of the bowels 
by mild and unirritating aperients. If the stomach 
contain irritating substances an emetic should be 
given to remove them. To relieve the pain and 
spasm a mustard plaster or hot fomentations may 
be applied to the abdomen ; and chloral, chloroform, 
morphine, or some similar remedy, may be adminis¬ 
tered internally. 

Lead colic, copper colic, etc., can only be cured 
by the elimination of the poisonous snbstances 
which cause the colic, from the system ; to accom¬ 
plish this the bowels must be kept open, and such 
remedies administered as existing circumstances 
may indicate. 

Constipation. An insufficiency of evacuations 
from the bowels is called constipation or costive¬ 
ness. It may be caused by an excessive action 
of the absorbents of the bowels, or defective 
secretion of the juices of the intestines, by which 
the faeces become hardened, or by an impaired 
peristaltic action of the intestines. It exists as 
a functional disorder, and is incidental to various 
affections. It arises most frequently from a defi¬ 
ciency or vitiated secretion of the bile, which is 
the natural stimulus of the bowels. Sedentary 
habits and the use of certain kinds of food pre¬ 
dispose to it. 


Intestinal Worms. 


3 7i 


The treatment of constipation involves manage¬ 
ment as well as medicines. The bowels may be 
opened by means of purgatives, or injections of 
warm water or warm soapsuds, after which the 
natural state of the system should be restored 
by the use of food of a laxative nature, open 
air exercise, bathing, etc. It is well also to have 
a regular time to endeavor to empty the rectum; 
but severe straining should be avoided, as it tends 
to induce piles. 

Intestinal Worms. The worms occasionally found 
inhabiting the human intestinal canal are of 
seven different kinds; and the number of para¬ 
sites met with in the human body exceeds thirty. 
There is scarcely a tissue or organ in which 
they are not known to lodge and nourish them¬ 
selves. 

The eggs and larvae of the worms gain admis¬ 
sion into the stomach with-impure drinking water, 
and also through the use of raw or insufficiently 
cooked food, especially pork. 

The presence of worms in the bowels produce 
various symptoms, such as itching of the nostrils 
and anus, voracious or impaired appetite, foulness 
of the breath, bluish circle round the eyes, dis¬ 
turbed sleep, grinding the teeth at night, swell¬ 
ing of the abdomen, and irregular bowels; but 
the only reliable sign is the passage of some of 
the worms, or portions of them, in the faeces. 


372 Diseases of the Alimentary Canal. 

The expulsion of intestinal worms is generally 
effected by the administration of anthelmintic 
remedies and brisk purgatives. Santonine, worm- 
seed, pinkroot, oil of turpentine, male fern, 
kousso and pumpkin-seeds are some of the anthel¬ 
mintics frequently used for the destruction of 
worms. The remedy used is most likely to be 
effective when the bowels do not contain an 
accumulation of faeces or partially digested food, 
and when the vigor of the parasite is reduced 
by a low and simple diet. Those affected with 
worms should use plenty of salt with their food. 


IX.—DISEASES OF THE LIVER. 


The greater number, and by far the more 
important of the affections of the solid abdomi¬ 
nal viscera, are seated in the liver; but as there 
are symptoms and signs which are common to 
many diseases, it is difficult for a person inex¬ 
perienced in diagnosing diseases to determine to 
which of its many sources a particular symptom 
ought to be referred; therefore, symptoms depend¬ 
ing upon disease of the stomach, intestines, kid¬ 
neys or heart, are often ascribed to derange¬ 
ments of the liver; and we frequently hear peo¬ 
ple say that they are “very bilious,” or their 
“liver is out of order,” or that they have “the 
liver complaint,” when in reality their liver may 
be perfectly healthy. 

The position of the liver in health, its weight, 
function, etc., have been described under the 
head of “The Liver.” The organ is liable to 
displacement by tight lacing, by rickets, by fluid 
in the pleura, or pericardium, by a large and 
dilated heart, and by tumors in the chest. Dis¬ 
placement can only be ascertained by those expe¬ 
rienced in the art of percussion, and must not 

373 


374 Diseases of the Liver . 

be mistaken for enlargement. The diseases which 
lead to enlargement are congestion, hypertrophy, 
inflammation, abscess, fatty degeneration, tumors 
and cancer; and also enlargement of the gall¬ 
bladder, which may be due either to an accu¬ 
mulation of bile, owing to some impediment to 
its escape into the intestine, or to inflammation 
of the coats followed by suppuration, or to can¬ 
cerous infiltration of the walls, or to the pres¬ 
ence of gall-stones. The liver diminishes in size 
and weight when affected with the disease known 
as “atrophy,” which is a very fatal affection. 

A detailed account of the various diseases of 
the liver will not be given by the writer, as it 
would be of no special interest to the general 
reader. One of the most frequent causes of dis¬ 
ease of this organ is the excessive use of alco¬ 
holic drinks, especially those undiluted, as they 
are more rapidly absorbed from the stomach than 
those mixed with water, and consequently produce 
much greater irritation of the liver. That condi¬ 
tion of the liver called “hob-nailed,” but profes¬ 
sionally known as “cirrhosis,” is one of the 
most common results of continued intemperance. 
It generally occurs in those beyond the middle 
period of life, and recovery from it is not to be 
expected. It usually ends fatally within a year 
or so, and all that can be done is to modify 
the severity of its symptoms by appropriate treats 


Congestion of the Liver. 


375 


ment. Drunkards are also apt to have “fatty 
livers,” which form of degeneration is common in 
those suffering from prolonged debility. 

Congestion of the Liver. Congestion of the 

liver is the initiative step in almost all the struc¬ 
tural diseases of this organ. It may result from 

some disease of the heart or lungs which obstructs 
the circulation of blood through the hepatic and 
portal viens ; it is also caused by high living, 
malarious influences in hot climates, the excessive 
use of alcoholic drinks, and functional disorder 

of the liver itself. Temporary congestion of the 
liver often follows violent exercise — particularly 
exercise soon after meals ; and to this is probably 
due that sudden “ side ache,” or “stitch in the 

side,” which is often experienced and which com¬ 
pels the sufferer to rest a few minutes. 

The symptoms of congestion of the liver are a 
sense of weight and fulness in the vicinity of the 
organ, nausea, foul tongue, headache or dizziness, 
slight jaundice and torpor of the bowels. The 
treatment consists in causing a drain from the 
portal system by the use of saline purgatives. 

Inflammation of the Liver. Inflammation of the 
liver is particularly common in tropical regions, 
and often occurs in temperate climates. It is 
attended by pain in the region of the liver, which 
is increased on pressure, deep inspiration or 
cough. There is inability to lie on the left side, 


376 


Diseases of the Liver. 


difficulty in breathing, vomiting, cough, hiccough, 
a yellow tinge to the eyes, and sometimes jaun¬ 
dice. 

When the inflammation is deep-seated and con¬ 
fined to the substance of the liver, the pain is 
dull and tensive; but when it extends to the 
surface of the organ, or is seated in the peritoneal 
covering, the pain is sharp and lancinating. The 
disease often ends in abscesses which sometimes 
require to be opened externally. When inflam¬ 
mation of the liver has supervened in a warm 
climate, a removal to a more temperate region is 
always advisable. The medical treatment is com¬ 
plicated, and professional assistance is necessary. 
After the disease has been subdued, vegetable 
tonics are useful in restoring the digestive powers. 

' Gall-stones. The gall-bladder is liable to have 
a number of calculi or gall-stones of various sizes 
and shapes, but usually about the size of a pea, 
formed in its cavity from the salts of the bile. 
The passage of these biliary formations through 
the duct, from the gall-bladder to the intestines, 
is attended with acute and distressing pain. 
When the calculi with its jagged and rough edges, 
gets past the neck of the bladder and into the 
duct, spasmodic contraction of the latter occurs, 
causing sudden paroxysms of pain, so severe that 
the sufferer may be semi-collapsed; intervals of 
relief succeed the pain. The attack is usually 


Jaundice . 


3 77 


accompanied by nausea, vomiting and profuse per¬ 
spiration. If the gall-stone escapes into the intes¬ 
tines, immediate relief follows, and if it be true 
as some philosopher has remarked, that the height 
of happiness is sudden relief from great suffering, 
the patient is indeed a happy man. If the gall¬ 
stone does not escape into the intestine, jaundice 
is developed by its obstructing the passage of 
bile. 

Most people are never afflicted with these attacks, 
but certain persons are particularly liable to them. 
They are commonly known as “bilious colic.” 

The treatment consists in relaxing the system 
as quickly as possible; allay the pain by the use 
of anodynes, and, if it can be effected, expand 
the biliary duct by means of a hot bath. 

Jaundice. Jaundice is characterized by yellow¬ 
ness of the skin, eyes, and tissues generally, from 
impregnation of bile pigment. It is often spoken 
of as a separate disease, but is, in fact, only a 
symptom of disordered action of the liver. It is 
generally produced by some impediment to the 
flow of bile into the intestine, and the consequent 
absorption of the retained fluid into the blood. 

The yellow color appears first in the eyes, then 
the face, neck, chest, and finally the entire body 
becomes imbued with it. The shades of yellow¬ 
ness vary from a light yellow to a deep orange 
hue, and in some cases greenish or almost black. 


£ 


378 


Diseases of the Liver. 


The latter varieties are the most dangerous, and 
are known as green or black jaundice. 

Jaundice may be developed gradually or sud¬ 
denly. In the former case the yellowness of the 
skin is preceded by headache, loss of appetite, 
nausea, irregular bowels, or constipation, colic, pains, 
languor, etc. With sudden attacks the yellowness 
is the first symptom. The urine acquires a 
saffron color as the disorder advances, and the 
faeces a light clay color. There is usually a 
troublesome itching or tingling sensation of the 
surface of the body, a bitter taste in the mouth, 
furred and yellow tongue, thirst, drowsiness, giddi¬ 
ness, peevishness and exhaustion. 

The duration of jaundice varies from a few 
days to several weeks. When acute, it is not 
very often fatal; but when it lasts a month or 
two, and when acute, yellow atrophy of the liver 
exists, there is always danger connected with its 
organic cause. 

In the treatment of jaundice the object is to 
promote the secretion of bile, and favor its 
removal. In that form of the disorder which is 
independent of obstruction of the bile duct, this 
is best accomplished by the administration of 
cathartics. Alkalies, and their salts, with the veg¬ 
etable acids, are also useful, partly in correcting 
acidity of the stomach, but mainly by carrying 
off by the kidneys the products of blood and 


Jaundice. 


379 


tissue metamorphosis, the presence of which in the 
blood is the probable cause of the languor and 
other symptoms from which the patient suffers. 
Fermented liquors, wine, spices, fat and all rich 
or indigestible articles of diet which are calcu¬ 
lated to irritate or congest the liver, must be 
avoided. When the jaundice is dependent upon 
obstruction of the bile ducts, warm baths and 
opiates are useful. 


X. —DISEASES OF THE KIDNEYS. 



The structure and functions of the kidneys 
have been described under the head of “The 
Kidneys.” These organs are subject to a variety 
of dangerous and painful diseases, which may be 
arranged in two distinct classes; viz. : those 
which are the result of some cause acting 
locally, and those which are the result of a con¬ 
stitutional cause. 

Retention of urine, calculus or gravel, and 
external violence, are local causes. Scrofulous 
disease of the kidneys, cancer, hydatids, etc., are 
produced by constitutional causes. 

Inflammation of the kidneys, professionally 
called nephritis, like other inflammatory diseases, 
results from cold, wet, sudden changes in tem¬ 
perature, intemperance, etc. 

Bright's Disease. Structural disease of the 

kidneys, characterized by albuminuria and dropsy, 

is called “Bright’s disease,” because Dr. Bright, 

in the year 1827, was the first to draw attention 

to the existence of this singular affection. Since 

his time, it has been shown that not one kind, 

but many different structural alterations of the 

380 


Bright's Disease. 381 

kidneys, are connected with albuminuria and 
dropsy. 

Bright’s disease may be the result of con¬ 
gestion, of acute inflammation, of albuminoid 
changes, of cirrhosis, and of fatty degeneration. 
It more frequently occurs in men than in women. 
The acute form of the disease usually results 
from exposure to cold and wet, checked perspira¬ 
tion, the excessive use of alcoholic drinks, and 
especially scarlet fever; and consists essentially 
of an affection of the gland cells, lining the con¬ 
voluted uriniferous tubes, induced by their having 
to eliminate from the blood some matter which 

is not naturally excreted by the kidneys ; or, if 

natural, is present to a morbid excess. The cir¬ 
culation of unhealthy blood through the kidneys 
must impair the renal cells, whether the blood 

be altered by the constant presence of alcohol, 
or by injurious matters generated within the 
system, or by the poisons of the eruptive fevers. 
While the gland cells are undergoing destructive 
changes, the materials which ought to be elimi¬ 

nated from the system by the kidneys, are more 
or less retained; their accumulation in the blood 
increasing its deterioration so that this again 
aggravates the original mischief, the disease thus 
becomes fully developed. 

The symptoms of acute Bright’s disease com¬ 
mence with chilliness, soon followed by feverish 


382 


Diseases of the Kidneys. 


reaction, headache, restlessness, oppression in breath¬ 
ing, nausea, perhaps vomiting, pains in the back 
and limbs — the symptoms of inflammation — with 
dropsy, which is first observed as puffiness about 
the eyes and face in the morning, and frequent 
urination; but the urine is scanty, heavy, acid in 
reaction, and very albuminous. 

Albumen in the urine is revealed by chemical 
tests — heat and nitric acid. Heat coagulates the 
albumen when the urine is acid, and produces a 
cloud varying in density; alkaline urine must be 
rendered acid by the addition of a drop or two 
of nitric acid and heat then applied. Urine con¬ 
taining an excess of earthy phosphates will 
become cloudy on the application of heat, therefore 
we employ nitric acid, which dissolves the phos¬ 
phates, but renders the albuminous deposit per¬ 
manent. Nitric acid alone will coagulate albuminous 
urine; but to be sure that it consists of albumen, 
it is best to test also by heat. It should be 
remembered that temporary albuminuria may occur 
in many diseases and yet the patient not 
have Bright’s disease. In Bright’s disease the 
albumen persists, and what are called epithelial 
tube casts are detected in the urine. 

The acute form of Bright’s disease proceeds 
to one of three terminations within a few weeks ; 
viz.: recovery, death, or lapse into the chronic state. 
Probably about two thirds of the cases recover. 


Diabetes. 


383 


The treatment consists in opening the pores of 
the skin by means of hot water and hot air 
baths; keeping the bowels free by purgative 
medicines : and relieving the kidneys by dry cups 
over the loins. The diet should be liquid, and 
simply nutritious. Alcoholic drinks and powerful 
diuretics should be avoided. After the feverish 
phenomena have subsided, the quality of the blood 
may be improved, and the escape of albumen 
diminished by taking the tincture of chloride of 
iron. The patient should long avoid sudden 
changes in temperature, cold, and dampness. 

Chronic Bright’s disease may be developed so 
slowly that the sufferer is not aware of his afflic¬ 
tion until after the lapse of months or years. 
There is gradual loss of strength, pallor or puffi¬ 
ness of the face, a frequent desire to urinate, and 
perhaps shortness of breath, but the occurrence of 
dropsy often first draws attention to the state of 
the kidneys. As chronic Bright’s disease tends 
toward a fatal result, those who suspect that they 
may be afflicted with it, should seek the advice 
of an honest physician skilled in diagnosing 
diseases. 

Diabetes. Diabetes is a complicated disease 
characterized by an excessive flow of urine. Two 
distinct forms of the disease are recognized, viz., 
diabetes insipidus and diabetes mellitus. The for¬ 
mer is also known as diuresis, and is merely a 


384 


Diseases of the Kidneys. 


greatly increased flow of almost colorless urine, 
containing neither sugar nor albumen. In the 
latter there is not only a greatly increased flow 
of urine, but the urine contains a large quantity 
of sugar, the presence of which is ascertained 
by chemical tests. 

Men are more frequently afflicted with diabetes 
than women, especially those with a debilitated 
constitution. The occurrence of the disease is 
favored by hereditary predisposition, and it gener¬ 
ally comes on slowly and imperceptibly without 
any apparent disorder of the system; it may 
exist for a long time before it attracts attention. 
It commences with a feeling of indisposition, 

excessive urination, slight loss of flesh, parched 
mouth and intense thirst. The patient has to 
micturate several times during the night, the skin 
'becomes harsh and dry, there is muscular debil¬ 

ity, and the sexual and mental powers fail by 
degrees. The sufferer becomes gradually more 

and more exhausted, and the disease often termi¬ 
nates in, or becomes associated with, pulmonary 
consumption. 

Diabetes mellitus generally proves fatal, but 
frequently is only the indirect cause of death. 

A diabetic individual, in addition to his liability 
to consumption, is apt to suffer from boils or 
carbuncles, or from bronchitis, or from chronic 
pneumonia, or from gangrene of an extremity. 


Diabetes. 


385 


In the treatment of diabetes, the first and 
most important point is to regulate the diet, 
which should be nutritious and as free as possi¬ 
ble from saccharine or amylaceous substances. 

The sufferer holds his fate in his own hands. 
If he will exercise self-control, and be satisfied 
to eat that he may live, instead of eating to 
please his taste, his life may be prolonged for 
some years, provided there be no organic disease, 
and that complications do not arise. Fish, oysters, 
clams, poultry, and meat of all kinds, excepting 
liver, may be partaken of freely, with butter, 
cream, cheese, eggs, and such vegetables as are 
deficient in sugar and starch, as greens, lettuce, 
cabbage, cauliflower, spinach, celery, water-cresses,v 
onions and asparagus. 

Vegetables which abound in sugar or starch, 
such as beets, parsnips, carrots, turnips, potatoes, 
beans, peas, etc., must not be eaten. Rice, sago, 
tapioca, arrowroot, chestnuts, confectionery, and 
bread and cakes, made of wheat or rye flour, 
corn or oatmeal, must also be avoided. The 
desire for bread may be supplied by the use of 
gluten bread, bran bread, or almond bread. Tea 
and coffee without sugar are allowable. Acid 
fruits may sometimes be moderately indulged in. 
Beer, cider, sweet wines, and liquors should be 
avoided; when stimulants are needed by the 
system, a little brandy and water, or claret, or 


386 


Diseases of the Kidneys. 


Burgundy wine, or dry, sound sherry wine may 
be used. 

Sudden changes in temperature, cold and damp, 
are especially to be avoided. The body should 
be protected by suitable clothing, flannel being 
worn next to the skin. Warm baths, brisk fric¬ 
tion, etc., are useful. A long sea voyage in a 
warm latitude has been found beneficial. Mental 
relaxation, recreation, and exercise in the open 
air, are an important part of the regimenal 
treatment. Among the useful medicines are the 
alkalies, opium, strychnia, and cod liver oil. 



XL —DISEASES OF THE SKIN. 


The skin is liable to many diseases, which vary 
greatly in their importance and general charac¬ 
ters. Some are attended with no danger, others 
are dangerous to life; some are attended with 
fever, and are rapid in their course; others are 
chronic and obstinate ; some are contagious, others 
are not; some destroy beauty, others cause but 
slight disfigurement, etc., etc. 

Skin diseases are modified according as the 
patient is strumous, anaemic, plethoric, gouty, 
rheumatic, or dyspeptic; and also by the age 
and sex, the mode of life, and the residence of 
the sufferer. It should be remembered that many 
skin diseases are secondary affections, merely 
signs of constitutional derangement. 

The various diseases of the skin may be divided 
into eight classes, distinguished from each other 
by their appearance upon the skin as follows: 

1. Papules , or pimples, little elevations of the 
cuticle of red color, and not containing any fluid. 

2. Squamae , or scales, small, hard, thickened, 

opaque, whitish patches of unhealthy cuticle. 3. 

Exanthemata , or rashes, superficial red patches, 

387 


388 


Diseases of the Skin . 


varying in figure and size, and irregularly diffused 
over the surface. 4. Brillce, blebs, or miniature 
blisters. 5. Pustulce , or pustules, circumscribed 
elevations of the cuticle containing pus, and hav¬ 
ing red inflamed bases. 6. Vesiculce , or vesicles, 
small elevations of the cuticle covering a fluid, 
usually at first clear and colorless, but becoming 
afterwards opaque and whitish or pearly. 7. Tu¬ 
bercular tubercles, small, hard, superficial tumors. 
8. Maculce , spots or patches arising from excess 
or deficiency of the coloring matter of the skin. 

To cure diseases of the skin, both local and 
constitutional remedies are required; the latter 
being usually the most important. The object in 
employing constitutional remedies is (1st) to elim¬ 
inate from the system the morbid matter upon 
which the eruption depends, and (2d) to alter 
the constitutional state which led to the forma- 
mation of the poison, and thus restore the healthy 
tone of the body. The local remedies are of 
value in assisting the cure of the disease, and 
also in moderating irritation and pain. Local 
remedies alone generally give permanent relief in 
those skin diseases due to the presence of para¬ 
site. 


XII. — SURGICAL ACCIDENTS AND EMER¬ 

GENCIES. 


Wounds. A division or solution of continuity 
of the soft tissues produced by violence is called 
a wound. Wounds may be open or subcuta¬ 
neous, and are divided according to their nature 
and causes, into five classes; viz: (i.) Incised 
wounds, which consist of a simple division of 

the fibres made by a sharp cutting instrument; 
(2.) lacerated wounds; in these the edges are 
torn, usually irregular; (3.) contused wounds, or 

those in which the edges are bruised; contused 
wounds are usually also lacerated; (4.) punctured 
wounds; these are inflicted with the point of a 
weapon; they are generally narrow and deep, are 
always painful, and are apt to be followed by 
much swelling and inflammation; (5.) poisoned 

wounds, or those which result from snake-bites, 
the bites of rabid animals, the stings of insects, 
careless dissecting, etc. 

Wounds are dangerous according to their char¬ 
acter; i. e., whether incised, or lacerated, or 

poisoned, or otherwise; the extent of the soft 

parts which they involve, the parts they occur 

389 


390 Surgical Accidents and Emergencies. 

in, the age, habits, surroundings and state of 
health of the patient and the treatment which 
they receive. The consequences of a wound are 
pain, hemorrhage, displacement, loss of function 
and shock. Loss of function may be stiffness, 
paralysis, deformities, or death. 

The first attention generally required by wounds 
is to wash and gently cleanse the parts which 
may happen to be covered with dirt, and check 
the hemorrhage. (See Hemorrhage.) Then the 
edges of the wound are to be brought together, 
and retained either by adhesive plaster or a few 
stitches. Simple incised wounds generally heal 
quickly without any suppuration taking place, or, 
as it is said, “by first intention.” Should this 
not be the case, and suppuration come on, poul¬ 
tices and warm dressings should be used to 
remove inflammation, and afterwards healing oint¬ 
ments applied. Suppuration almost always takes 
place in lacerated and contused wounds, and the 
swelling and inflammatory symptoms which com¬ 
monly attends them, are to be diminished by 
cooling lotions and emollient poultices. The same 
general principles apply to punctured wounds. 
The best advice that can be given in cases of 
poisoned wounds is to promptly apply for relief 
to the most skilful physician within reach. (See 
Hydrophobia.) 

Fractures. The fractures to which the bones of 


Fractures. 


391 


the skeleton are liable, are divided into complete, 
incomplete, simple, comminuted, compound, and 
impacted. The main peculiarities of fractures are 
expressed by these terms. Complete fractures are 
classified into transverse, oblique, longitudinal, 
dentate, and comminuted. Incomplete fractures — 
partial separation of bones — include fissures, in¬ 
fractions, splintering and perforation; the latter 
being peculiar to gunshot injuries. 

The causes of fractures are predisposing and 
exciting; predisposing causes are an exposed sit¬ 
uation, occupations, adult age and disease of the 
bones; exciting, determining, or immediate causes 
of fractures are either direct or indirect violence 
or muscular action. 

The symptoms of fracture are pain, swelling, 
crack felt or heard by patient when fracture 
occurs, abnormal mobility, displacement, crepitus, 
loss of function, and injury to neighboring soft 
parts, as compression of the brain by fracture of 
the skull. One or more of the above signs may 
be absent. 

The treatment of fractures consists of (1) re¬ 
storing the fragments to place as completely as 
possible; (2.) to maintain them in place; and 

(3.) to prevent or to control inflammation, spasms, 
and other accidents. Although simple fractures 
are sometimes very easily cured, it is always 
best for the injured person to place himself 


392 Surgical Accidents and Emergencies. 

without delay, in charge of an experienced 

surgeon. 

Dislocations. When the bones which enter into 
the formation of a joint are displaced as regards 
their relative position, they are said to be dislo¬ 
cated. (See The Joints, or Articulations.) 

Dislocations are usually divided into three 
classes, viz. : (i.) Accidental or traumatic, when 
they result from the sudden application of force ; 
(2.) spontaneous or pathological, when they occur 
from an alteration in a joint as the result of 
disease; the dislocation of the femur in hip 
disease is an illustration; (See Coxalgia, or 
Hip Disease.) (3.) Congenital, when they exist 
at the moment of birth. When the term “ dislo¬ 
cation ” is used alone, it is generally understood 
to mean the accidental variety. 

Dislocations are further classified, by surgeons, 
as complete, or partial; as simple, compound or 
complicated ; as recent, or old; and as primitive, 
or consecutive. 

The symptoms of dislocations are change in the 
shape of the joint, lengthening or shortening of 
the limb, pain and inability to move the limb. 

The general treatment of dislocations consists 
in their reduction or pulling the displaced bone 
back into its place. The sooner this is accom¬ 
plished the better. As the chief obstacles to 
reduction are muscular resistance and the anatom- 


Asphyxia. 


393 


ical relations of the joint, a correct anatomical 
knowledge is important; still a person unacquainted 
with anatomy or surgery may occasionally succeed 
in reducing a dislocated limb, but there is a vast 
difference between mere chance and brute force 
on the one hand, and an intelligent manipulation 
on the other. An experienced surgeon should 
always be consulted. In former days, when there 
was great difficulty in reducing a dislocated limb, 
bleeding, emetics, and the warm bath were gener¬ 
ally made use of to remove the spasm of the 
muscles; but at the present time chloroform or 
ether are administered to accomplish the same 
end. 

Asphyxia. As asphyxia may be produced by 
whatever prevents the access of air to the lungs, 
the treatment for suspended animation in cases 
of drowning, strangulation, suffocation, etc., must be 
essentially the same in principle. The patient 
should be treated instantly, on the spot, in the 
open air. Loosen all clothing, especially about the 
neck and chest. Place the patient gently on his 
face, with one arm under his forehead, draw the 
tongue forward, and clear the mouth so that any 
fluids that may be in the mouth or throat will 
be removed. Now lose no time, but imitate 
respiration ; turn the patient gently but completely 
on his side and a little beyond; then on the 
face again. Repeat these movements fifteen times 


394 Surgical Accidents and Emergencies. 

in the minute until the patient shows signs of 
life. 

Another method of performing artificial respi¬ 
ration consists in laying the patient on his back, 
drawing the tongue forward, and raising both 
arms as far as possible above the head, when 
inspiration will occur; then bend the elbows, 
turn the arms downward and press them gently 
but firmly against the sides of the chest, when 
expiration takes place. Now stretch the arms at 
full length above the head again, and thus con¬ 
tinue these movements perseveringly fifteen times 
in the minute until signs of life return. 

A little ammonia or other irritants applied to 
the nostrils at intervals, will aid to excite the 
nerve-centres. When the patient begins to breathe, 
commence rubbing the limbs and body vigorously 
towards the heart , to restore the venous circula¬ 
tion ; and as consciousness returns, a small 
quantity of ginger tea or alcoholic stimulants 
may be given. 

Poisons. A poison is any substance which, 
when absorbed into the blood, is capable of 
seriously affecting health, or of destroying life. 
Poisons may be introduced into the body in 
various forms, and their affects are local and 
constitutional. 

The treatment in all cases of poisoning is (ist) 
to remove the poison from the system; (2d) to 


Poisons . 


395 


stop its action, if it cannot be readily and imme¬ 
diately removed ; and (3d) to remedy the 
mischief it has done, and obviate the tendency 
to death. 


- 


GENERAL INDEX. 


Absorption, 91. 

Accidents, 389. 

Adipose tissue, 81. 

Ague, 277. 

Air, pure, 143. 

Alcoholic drinks, 188. 
Alimentary canal, 85. 
Alimentary canal, diseases of, ; 
Alimentation, 89. 

Animal heat, 102. 

Apoplexy, 305. 

Arteries, 70. 

Arteries, systemic and pulmonic, 
Articulations, 32. 

Asphyxia, 393. 

Assimilation, 92. 

Asthma, 347. 

Barley water, 171. 

Beef tea, 170. 

Bladder, 106. 

Blood, 83. 

Blood, circulation of, 68. 

Blood, morbid states of, 230. 
Boils, 235. 

Boneset tea, 173. 

Bones of the skeleton, 19. 
Brachial plexus, 50. 

Brain, 45. 

Brain, inflammation of, 303. 
Bright’s disease, 380. 

Bronchitis, 335. 

Broths, mutton, chicken & veal, 
Buchu tea, 172. 


Cancer, 265. 

Capillaries, 74. 

Carbuncles, 235. 

Caries of the spine, 245. 
Catarrh, 332. 

Cavity, ear, 24. 

Cavity, nose, 27. 

Cavity, oral, 28. 

Cayenne pepper tea, 172. 
Cerebro-spinal fever, 274. 

Chest, 30. 

Chewing tobacco, 211. 

j.Chicken-pox, 294. 

Cholera, 366. 

Chorea, 327. 

Circulation of blood, 68. 

Clove tea, 173. 

Colic, 369. 

Complete man, 114. 

Condiments, 162. 

Congestion of the liver, 375. 
Constipation, 370. 

Consumption, 343. 

Continued fever, 267. 
Convulsions, 321. 

Cord, spinal, 47, 

Correlation and convertibility of 
forces, 124. 

Cough, see “ Bronchitis ” and 
“ Consumption.” 

Cough, whooping, 351. 

Cow-pox, 292. 

.Coxalgia, 246. 

Croup, 349. 


Canal, alimentary, 85. Death, 226. 

Canal alimentary, diseases of, 359-Deglutition, 89. 

397 


39 « 


General Index. 


Developed man, 114. 

Development, 109. 

Diabetis, 383. 

Diarrhoea, 363. 

Different kinds of drinks, 164. 
Different kinds of food, 158. 
Different kinds of force, 123. 
Digestion, 89. 

Diphtheria, 353. 

Disease, 220. 

Diseases, general, 230. 

“ infectious — how to pre¬ 
prevent, 285. 

of alimentary canal, 359, 
of the heart, 356. 
of the kidneys, 380. 
of the liver, 373. 
of nervous system, 302. 
of organs of respira¬ 
tion, 332. 

of the skin, 387. 
Disinfection, instructions for, 287. 
Dislocations, 392, 

Drinks, different kinds of, 164. 
Drinks, preparation of, 164. 
Drinks, alcoholic, 188. 

Drinking, facts and fallacies con¬ 
cerning, 175. 

Dropsy, 260. 

Duration of life, 132. 

Dysentery, 365. 

Dyspepsia, 360. 


U 


Eye sockets, 23. 

Eyes, see “ Sense of Sight 

Facts and fallacies, 175. 

Face, largest bones of, 22. 

Fat, 81. 

Fever, cerebro-spinal, 274. 

“ intermittent, 277. 

“ relapsing, 276. 

“ remittent, 281. 

“ scarlet, 296. 

“ simple continued, 267. 

“ typhoid, 271. 

“ typhus, 268. 

“ yellow, 281. 

Fevers, 267. 

“ eruptive, 284. 

Five senses, 60. 

Flaxseed tea, 174. 

Food, different kinds of, and their 
mode of preparation, 158. 

Force, different kinds of, 123. 

Forces, correlation and convert¬ 
ibility of, 124. 

Fractures, 390. 

Function of nervous system, 55. 

Gall-stones, 376. 

Generative organs, 108. 

General diseases, 230. 

Gout, 257. 


Ear cavity, 24. 

Eating, facts and fallacies con¬ 
cerning, 175. 

Emergencies, 389. 

Epilepsy, 323. 

Eruptive fevers, 284. 

Erysipelas, 299. 

Exercise, 148. 

Extremeties, lower, 31. 
Extremeties, upper, 32, 


Headache, 311. 

Health, how to preserve it, 140. 
“ man’s stature and weight 
in relation to, 129. 

“ what is it ? 128. 

Hearing, sense of, 64. 

Heart, 68. 

Heart, diseases of, 356. 

Heat, animal, 102. 

Hemorrhage, 237. 

Hip disease, 246. 





General Index. 


399 


Human skull, 22. 

Hydrophobia, 262. 

Hysteria, 325. 

Infectious diseases, how to pre¬ 
vent their spread, 285. 
Inflammation, 233. 

Inflammation of brain, 303. 
Inflammation of liver, 375. 
Insalivation, 89. 

Insanity, 313. 

Instructions for disinfection, 287. 
Intermittent fever, 277. 

Intestinal worms, 371. 
Introduction to part I, 13. 

“ “ “ II, 121. 

“ “ “ III, 219. 

Jaundice, 377. 

Joints, 32. 

Juniper berry tea, 174. 

Kidneys, 104. 

Kidneys, diseases of, 380. 

Larynx, 96. 

Life, duration of, 132. 

“ how to sustain it, 140. 

“ what is it? 123. 

Liver, 87. 

“ diseases of, 373. 

“ congestion of, 375. 

“ inflammation of, 375. 
Lungs, 99. 

Lymphatics, 77. 

Man, fully developed and com¬ 
plete, 114. 

Man’s stature and weight, 129. 
Mastication, 89. 

Measles, 295. 

Morbid states of the blood, 230. 
Mouth, 28, 


Mumps, 359. 

Muscles, 35. 

Narcotics, 206. 

Nasal fossae, 27. 

Nerve, largest in the body, 51. 
Nerves, cranial, 52. 

“ spinal, 48. 

“ lumbar and sacral, 51. 

“ of the body, most im¬ 

portant, 49. 

Nervous system, diseases of, 302. 
“ “ its function, 55. 

“ “ its structure, 42. 

Neuralgia, 330. 

Nutrition, 93, 

Opium, its use and abuse, 207. 
Oral cavity, 28. 

Orbits, 23. 

Organ of voice, 96. 

Organs, generative, 108. 

“ urinary, 104. 

Pancreas, 88. 

Paralysis, 307. 

Pelvis, 31. 

Phthisis, 343. 

Pleurisy, 338. 

Plexus, brachial, 50. 

Plexuses, lumbar and sacral, 51. 
Pneumonia, 341. 

Poisons, 394. 

Portal system, 75. 

Preparation of food, 158. 

Quinsy, 369. 

Recreation, 148. 

Relapsing fever, 276. 

Remittent fever, 281. 
Reproduction, 108. 

Respiration, 99. 




400 


General Index. 



Respiration, diseases of the 
organs of, 332. 
Rheumatism, 252. 

Rice water, 171. 

Rickets or rachitis, 248. 

Sage tea, 175. 

Saint Vitus’s dance, 327. 

Salivary glands, 86. 

Scarlet fever, 296. 

Scrofula, 241. 

Senses, five, 60. 

Sight, sense of, 61. 

Skeleton, bones of, 19. 

Skull, human, 22. 

Skin, 35. 

Skin, diseases of, 387. 

Sleep, its necessity, 151. 
Small-pox, 289. 

Smell, sense of, 65. 

Smoking tobacco, 211. 

Snuffing tobacco, 211. 

Spinal cord, 47. 

Spinal nerves, 48. 

Spine, 29. 

Spine, caries of, 245. 

Spleen, 94. 

Stature, man’s, 129. 

Styes, 235. 

Sunstroke, 309. 

Surgical accidents, 389. 

System, function of the nervous, 
System, portal, 75. 

“ structure of nervous, 42. 


System, vascular, 68. 

Systemic arteries and veins, 76. 
Syphilis, 249. 

Tar water, 174. 

Taste, sense of, 66. 

Tetanus, 328. 

Thorax, 30. 

Tissue adipose, 81. 

Tobacco, 211. 

Tonsillitis, 356. 

Touch, sense of, 67. 

Trachea, 97. 

Typhoid fever, 271. 

Typhus fever, 268. 

Ureters, 106. 

Urethra, 107. 

Urinary organs, 104. 

Vaccine, 292. 

Vascular system, 68. 

Veins, 74. 

Veins, systematic and pulmonic,76. 
Vertebral column, 29. 

Voice, organ of, 96. 

Weight, man’s, 129. 

What is health? 128. 

What is life ? 123. 

Whooping cough, 351. 

1.Worms, 371. 

Wounds, 389. 

Yellow fever, 281. 


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LBJe 14 




















